go back

Vermont rates for HCPCS J1442

Injection Filgrastim (G-Csf) Excludes Bio- Similiars 1 Microgram (Revised 01/01/2016)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.11 / $1.70
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.12 / $1.12 / $1.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.94 / $1.11 / $1.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.94 / $1.11 / $1.85
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.95 / $1.06 / $1.12