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Montana rates for HCPCS J2788

Rho D Immune Globulin 50 Mcg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$318.00 / $318.00 / $318.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.89 / $33.71 / $63.80
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$113.94 / $77,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.96 / $26.96 / $76.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.59 / $25.59 / $26.96
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.96 / $26.96 / $76.61
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.59 / $27.76 / $36.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.59 / $25.59 / $25.59