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Montana rates for HCPCS J1944

Injection, aripiprazole lauroxil, (Aristada), 1 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.65 / $4.03 / $7.47
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
$3.71 / $3.71 / $7.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.35 / $3.35 / $3.71
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.71 / $3.71 / $7.96
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.35 / $3.63 / $4.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.35 / $3.35 / $3.35