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Idaho rates for HCPCS J2504

Injection Pegademase Bovine 25 Iu

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.56 / $416.56 / $416.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$333.25 / $354.08 / $416.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$367.96 / $367.96 / $367.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.96 / $367.96 / $367.96
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.08 / $379.73 / $512.28
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.44 / $229.29 / $229.29
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.00 / $78.00 / $78.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$198.89 / $238.67 / $373.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$357.54 / $357.54 / $409.27