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Montana rates for HCPCS J2916

Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.08 / $102.60 / $407.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.64 / $60.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.80 / $77,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.21 / $2.21 / $5.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.02 / $2.02 / $2.21
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.21 / $2.21 / $5.73
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.02 / $2.20 / $2.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.02 / $2.02 / $2.02