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California rates for HCPCS J1742

Injection Ibutilide Fumarate 1 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$303.30 / $752.77 / $828.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$252.14 / $303.30 / $828.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$266.58 / $360.18 / $736.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.50 / $310.61 / $606.60
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.09 / $100.00 / $401.96
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $208.93 / $522.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$310.61 / $310.61 / $310.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$310.61 / $310.61 / $310.61
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$393.93 / $393.93 / $393.93
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$372.88 / $1,581.00 / $1,581.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$257.81 / $310.61 / $433.72
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.77 / $310.61 / $609.49
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.83 / $562.83 / $562.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.30 / $298.30 / $767.53