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Michigan rates for HCPCS J1645

Injection Dalteparin Sodium Per 2500 Iu (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.04 / $18.57 / $57.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.54 / $17.04 / $21.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.44 / $36.83 / $69.67
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.61 / $3.80 / $3.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.06 / $16.54 / $16.54
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.54 / $32.52 / $51.70
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.54 / $17.04 / $19.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.44 / $19.02 / $20.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.54 / $16.54 / $17.55