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Idaho rates for HCPCS J1322

Elosulfase Alfa, Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$306.80 / $306.80 / $352.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.80 / $339.55 / $385.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$291.20 / $308.68 / $308.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$308.68 / $308.68 / $308.68
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$339.55 / $409.00 / $551.77
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$308.68 / $308.68 / $385.85
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$308.14 / $375.10 / $721.35
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$340.72 / $370.42 / $370.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$308.68 / $308.68 / $308.68