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Utah rates for HCPCS J1652

Injection, fondaparinux sodium, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.78 / $1.00 / $1.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.87 / $0.87 / $0.87
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.83 / $2.19
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.65 / $0.72 / $1.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.87 / $0.87 / $0.87