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West Virginia rates for HCPCS J2425

Injection Palifermin 50 Micrograms

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.74 / $35.74 / $36.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.54 / $35.54 / $36.27
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.54 / $53.33 / $53.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.54 / $35.54 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.54 / $35.54 / $48.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.54 / $35.54 / $42.11