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Montana rates for HCPCS J1458

Injection, galsulfase, 1 mg

Facilitymedian $501 · 10th–90th $417–$1,4130%20%10th90th$501Professionalmedian $513 · 10th–90th $490–$1,2880%20%40%10th90th$513$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $524.81 / $1,288.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $1,202.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $549.54
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $489.78 / $1,412.54
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $489.78 / $1,412.54
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $1,202.26
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $512.86 / $724.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $512.86