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Montana rates for HCPCS J1885

Injection, ketorolac tromethamine, per 15 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.48 / $21.85 / $88.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $2.00 / $6.17
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.62 / $77,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.56 / $0.56 / $1.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.30 / $0.56
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.56 / $0.56 / $1.70
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.33 / $0.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.30 / $0.30