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Montana 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
$28.50 / $28.50 / $906.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.85 / $36.85 / $164.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$84.13 / $84.13 / $184.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.74 / $37.74 / $84.13
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$84.13 / $84.13 / $184.77
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.74 / $77.65 / $100.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.00 / $37.00 / $37.00