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Wisconsin rates for HCPCS J1436

Injection Etidronate Disodium Per 300 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.67 / $64.67 / $144.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.67 / $64.67 / $80.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.70 / $68.70 / $101.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.04 / $177.52 / $251.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.88 / $76.09 / $92.34
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.67 / $64.67 / $64.67
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.82 / $39.82 / $39.82
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.67 / $64.67 / $64.67
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.84 / $80.84 / $105.09
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $55.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.67 / $64.67 / $64.67
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.82 / $39.82 / $39.82
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.84 / $68.84 / $125.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.84 / $80.84 / $105.09