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Montana rates for HCPCS J1364

Erythro Lactobionate /500 Mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.43 / $90.81 / $201.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.30 / $75.30 / $233.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $75.30
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.30 / $75.30 / $233.68
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $70.09 / $91.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $64.62