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Montana rates for HCPCS J1726

Injection, hydroxyprogesterone caproate, (Makena), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.14 / $20.14 / $1,280.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.58 / $23.58 / $23.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.64 / $19.64 / $19.64