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Iowa 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
$365.42 / $365.42 / $807.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.33 / $365.42 / $828.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.91 / $261.14 / $261.14
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.79 / $150.00 / $442.02
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$168.71 / $309.36 / $494.05
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$214.67 / $298.30 / $489.38
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$256.83 / $327.20 / $489.38
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.85 / $309.79 / $583.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.30 / $298.30 / $307.25
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$298.30 / $298.30 / $298.30
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.30 / $298.30 / $298.30