go back

Montana rates for HCPCS J1460

Injection Gamma Globulin Intramuscular 1 Cc (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.45 / $58.59 / $112.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.81 / $55.81 / $126.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.03 / $49.03 / $55.81
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.81 / $55.81 / $126.16
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.03 / $53.20 / $69.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.03 / $49.03 / $49.03