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Montana rates for HCPCS J1990

Chlordiazepoxide Injection

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.84 / $21.84 / $21.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.60 / $32.60 / $32.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.05 / $21.05 / $32.60
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.60 / $32.60 / $32.60
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.05 / $29.45 / $38.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.05 / $21.05 / $21.05