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Washington 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
$17.48 / $30.47 / $37.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.54 / $18.20 / $23.82
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.54 / $20.93 / $100.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.96 / $16.54 / $36.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.60 / $15.60 / $32.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.54 / $16.54 / $20.29
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.54 / $20.68 / $37.52
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.93 / $30.07 / $30.07
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.60 / $15.96 / $36.22
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.54 / $16.54 / $16.54
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.54 / $16.54 / $16.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.54 / $16.54 / $16.54