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Mississippi 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
$17.37 / $19.85 / $21.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.54 / $17.37 / $22.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.15 / $16.54 / $16.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.54 / $16.54 / $16.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.88 / $16.54 / $21.50