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Montana rates for HCPCS J2765

Injection, metoclopramide HCl, up to 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.15 / $18.62 / $63.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.10 / $3.02
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.29 / $64,565.42 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.29 / $1.29 / $3.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.07 / $1.07 / $1.29
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.43 / $1.10 / $3.31
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $1.10 / $3.31
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.29 / $1.29 / $3.63
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.95 / $1.51 / $85.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.07 / $1.07 / $1.07