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South Carolina 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
$299.64 / $1,211.44 / $2,422.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$299.64 / $304.27 / $419.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$250.02 / $508.28 / $963.97
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.14 / $112.66 / $140.83
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
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$94.72 / $329.60 / $404.51
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.35 / $553.35 / $553.35
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$289.29 / $305.76 / $382.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.30 / $298.30 / $298.30