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Vermont rates for HCPCS J1645

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.54 / $16.54 / $30.99
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.73 / $18.73 / $18.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.60 / $18.16 / $30.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.54 / $16.54 / $16.54
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.60 / $18.16 / $30.27
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.54 / $16.54 / $16.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.71 / $16.54 / $30.07