go back

Montana rates for HCPCS J2670

Injection, tolazoline HCl, up to 25 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $3.02 / $3.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.47 / $3.47 / $3.47
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.66 / $42.66 / $50.12
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $42.66 / $50.12
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.47 / $79.43 / $85.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.17 / $4.17 / $4.17