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Maryland 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
$11.65 / $24.02 / $42.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.85 / $37.74 / $44.22
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.52 / $11.52 / $11.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.74 / $37.74 / $37.74
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.79 / $80.34 / $173.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.00 / $37.00 / $44.38
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.68 / $46.68 / $46.68