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West Virginia rates for HCPCS J2504

Injection, pegademase bovine, 25 IU

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.08 / $354.08 / $433.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$345.74 / $354.08 / $354.08
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.28 / $137.62 / $240.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$178.20 / $367.96 / $367.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.96 / $367.96 / $745.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.08 / $357.54 / $416.56