go back

Montana rates for HCPCS J1930

Somatuline Depot SC SOLN 120 MG/0.5ML

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,586.23 / $18,586.23 / $18,586.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.04 / $34.39 / $44.36
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.92 / $68,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.15 / $45.15 / $208.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.04 / $34.04 / $45.15
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.15 / $45.15 / $208.08
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.04 / $36.94 / $59.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.04 / $34.04 / $34.04