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Montana rates for HCPCS J2250

Injection, midazolam HCl, per 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.27 / $18.60 / $90.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.16 / $0.19 / $1.70
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
$0.15 / $0.15 / $0.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.15
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.33
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.17 / $0.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.15