go back

Vermont rates for HCPCS J1260

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.98 / $5.98 / $10.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.17 / $6.17 / $6.17
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.17 / $6.17 / $6.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.37 / $12.93 / $18.77