go back

Montana rates for HCPCS J1322

Elosulfase Alfa, Injection

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$336.46 / $371.23 / $645.04
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$290.47 / $68,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$335.53 / $335.53 / $727.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$308.68 / $308.68 / $335.53
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$335.53 / $335.53 / $727.05
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$308.68 / $334.89 / $436.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$308.68 / $308.68 / $308.68