go back

Vermont rates for HCPCS J1458

Galsulfase Injection

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$508.76 / $508.76 / $868.47
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.95 / $575.95 / $575.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$479.96 / $548.91 / $914.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$508.76 / $508.76 / $508.76
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$479.96 / $548.91 / $914.86
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$508.76 / $508.76 / $508.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$507.35 / $508.76 / $782.63