go back

Montana rates for HCPCS J2562

Injection, plerixafor, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.61 / $144.56 / $957.06
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$618.44 / $77,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.51 / $28.51 / $1,076.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.33 / $25.33 / $28.51
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.51 / $28.51 / $1,076.33
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.33 / $27.49 / $60.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.33 / $25.33 / $25.33