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Idaho rates for HCPCS J2353

Injection Octreotide Depot Form For Intramuscular Injection 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$212.20 / $7,343.36 / $22,950.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.58 / $223.94 / $256.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$192.06 / $192.06 / $203.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.58 / $203.58 / $203.58
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.12 / $254.48 / $363.91
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.58 / $203.58 / $254.48
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$211.27 / $312.18 / $538.70
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$224.71 / $244.30 / $244.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.58 / $203.58 / $245.05