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Wisconsin rates for HCPCS J2797

Injection Rolapitant 0.5 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.85 / $1.90 / $1.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.85 / $0.88 / $1.06
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.89 / $0.89 / $0.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.90 / $1.47 / $2.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.77 / $0.90 / $1.19
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.85 / $0.90 / $1.06
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.85 / $0.90 / $1.06
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.92 / $1.02 / $1.20
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.23 / $58.40 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.85 / $0.88 / $1.06
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.90 / $0.90 / $90.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.90 / $0.90 / $0.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.92 / $0.98 / $1.09