go back

South Carolina rates for HCPCS J1260

Injection Dolasetron Mesylate 10 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.77 / $5.77 / $23.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.77 / $5.98 / $5.98
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.92 / $173.90 / $301.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.20 / $7.04 / $8.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.17 / $6.17 / $6.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.17 / $6.17 / $6.17
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.77 / $6.55 / $20.69
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.27 / $7.27 / $9.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.20 / $12.93 / $13.58