go back

Montana rates for HCPCS J1955

Injection, levocarnitine, per 1 g

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.73 / $29.39 / $54.55
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
$27.83 / $27.83 / $61.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.61 / $23.61 / $27.83
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.83 / $27.83 / $61.59
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.61 / $25.61 / $33.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.61 / $23.61 / $23.61