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Vermont rates for HCPCS J1631

Injection Haloperidol Decanoate Per 50 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.40 / $4.40 / $8.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.98 / $4.98 / $4.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.15 / $5.22 / $8.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.40 / $4.40 / $4.40
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.15 / $5.22 / $8.69
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.40 / $4.40 / $4.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.18 / $4.40 / $6.77