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Montana rates for HCPCS J2502

Injection, pasireotide long acting, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$569.42 / $682.19 / $682.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$601.52 / $601.52 / $601.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$572.96 / $572.96 / $601.52
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$601.52 / $601.52 / $601.52
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$572.96 / $621.61 / $1,716.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$572.96 / $572.96 / $572.96