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Arizona rates for HCPCS J3030

Injection, sumatriptan succinate, 6 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $77.62 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $37.15 / $154.88
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $23.99 / $44.67
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.11 / $107.15 / $199.53
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $47.86 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.70 / $25.70 / $25.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.70 / $25.70 / $25.70
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $51.29 / $125.89
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.15 / $37.15 / $37.15
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$269.15 / $269.15 / $269.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $37.15 / $48.98