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Oklahoma 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
$35.96 / $35.96 / $123.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.96 / $35.96 / $35.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.31 / $96.78 / $152.05
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 / $42.93
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.36 / $44.40 / $90.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.00 / $37.00 / $37.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.00 / $37.00 / $37.00