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Michigan 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
$234.49 / $292.33 / $912.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.33 / $292.33 / $292.33
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$196.58 / $354.13 / $669.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.77 / $48.18 / $48.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.90 / $310.61 / $310.61
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$292.33 / $365.43 / $813.44
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.33 / $316.20 / $379.44
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$235.81 / $235.81 / $235.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.30 / $298.30 / $316.47