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Montana rates for HCPCS J1943

Injection, aripiprazole lauroxil, (Aristada Initio), 1 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.54 / $3.94 / $7.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.59 / $3.59 / $8.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.24 / $3.24 / $3.59
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.59 / $3.59 / $8.15
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.24 / $3.52 / $4.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.25 / $3.25 / $3.25