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Utah rates for HCPCS J2250

Injection Midazolam Hydrochloride Per 1 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.38 / $23.92 / $69.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.18 / $0.49 / $24.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.15 / $0.18 / $0.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.14 / $0.15 / $0.15