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Montana rates for HCPCS J1267

Doripenem Injection

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.05 / $1.05 / $2.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.88 / $0.88 / $1.05
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.05 / $1.05 / $2.29
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.88 / $0.88 / $1.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.81 / $0.81 / $0.81