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Vermont rates for HCPCS J2820

Injection Sargramostim (Gm-Csf) 50 Mcg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.37 / $55.95 / $96.36
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.02 / $57.02 / $57.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.51 / $67.79 / $112.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.37 / $50.37 / $50.37
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.51 / $67.79 / $112.99
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.37 / $50.37 / $50.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.37 / $53.39 / $64.18