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Montana rates for HCPCS J1305

Injection Evinacumab-Dgnb 5mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.65 / $229.60 / $229.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$212.67 / $212.67 / $212.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$193.76 / $193.76 / $212.67
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$212.67 / $212.67 / $212.67
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$193.76 / $210.21 / $274.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$193.76 / $193.76 / $193.76