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Montana rates for HCPCS J2765

Metoclopramide Hcl Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.30 / $14.25 / $53.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.09 / $1.18 / $2.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.28 / $1.28 / $3.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.09 / $1.09 / $1.28
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.28 / $1.28 / $3.64
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.09 / $1.17 / $1.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.09 / $1.09 / $1.09