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Vermont rates for HCPCS J2515

Injection Pentobarbital Sodium Per 50 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.87 / $53.87 / $90.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.87 / $53.87 / $53.87
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.87 / $53.87 / $53.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.18 / $52.82 / $81.25