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Kentucky 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
$35.52 / $37.74 / $75.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.52 / $35.52 / $36.85
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.29 / $61.19 / $61.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.09 / $68.13 / $68.13
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.39 / $46.87 / $81.70
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.58 / $45.39 / $69.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.74 / $37.74 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.74 / $55.29 / $101.74
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $45.00 / $45.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.00 / $37.00 / $37.00