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Idaho rates for HCPCS J1726

Injection Hydroxyprogesterone Caproate (Makena) 10 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.62 / $20.62 / $20.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.41 / $20.62 / $20.86
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.62 / $22.11 / $29.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.00 / $78.00 / $78.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.46 / $21.69 / $38.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.64 / $19.64 / $19.64