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Montana rates for HCPCS J1595

Injection, glatiramer acetate, 20 mg

Facilitymedian $2,754 · 10th–90th $158–$2,8180%50%10th90th$2,754Professionalmedian $62 · 10th–90th $60–$2,7540%50%10th90th$62$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$60.26 / $61.66 / $63.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,511.89 / $5,495.41
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $2,511.89
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $2,754.23 / $2,818.38
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $2,754.23 / $2,818.38
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,511.89 / $5,495.41
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $85.11 / $3,090.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $63.10