go back

Montana rates for HCPCS J1454

Injection, fosnetupitant 235 mg and palonosetron 0.25 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $549.54 / $676.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $46,773.51 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $724.44 / $1,096.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $549.54 / $724.44
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $758.58 / $1,348.96
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $758.58 / $1,348.96
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $676.08 / $1,071.52
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $691.83 / $831.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $549.54 / $575.44