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Montana rates for HCPCS J1652

Injection, fondaparinux sodium, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.66 / $42.66 / $42.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.07 / $2.45 / $3.02
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.92 / $46,773.51 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.98 / $0.98 / $4.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.87 / $0.87 / $0.98
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.10 / $1.12 / $4.68
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.10 / $1.12 / $4.68
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.98 / $0.98 / $4.37
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $79.43 / $85.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.87 / $0.87 / $0.87