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Connecticut 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
$310.61 / $452.25 / $1,021.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$310.61 / $310.61 / $310.61
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$211.15 / $453.48 / $894.15
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.30 / $298.30 / $310.60
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
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$212.80 / $245.16 / $316.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$268.47 / $298.30 / $434.41