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Montana rates for HCPCS J1265

DOPamine HCl IV SOLN 40 MG/ML

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $0.80 / $1.47
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.18 / $77,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.81 / $0.81 / $2.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.81 / $0.83 / $0.83
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.81 / $0.81 / $2.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.83 / $0.91 / $1.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.83 / $0.83 / $0.83