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Connecticut 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) (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.75 / $54.95 / $158.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.74 / $37.74 / $37.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.25 / $65.64 / $135.06
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.00 / $37.00 / $37.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.74 / $37.74 / $37.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.74 / $37.74 / $37.74
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.25 / $72.25 / $72.25
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.81 / $11.51 / $15.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.29 / $37.00 / $176.91