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South Carolina 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
$32.17 / $58.63 / $447.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.50 / $36.40 / $38.33
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.06 / $34.21 / $125.43
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.38 / $3.84 / $4.76
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
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.79 / $40.04 / $49.15
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.70 / $69.70 / $87.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.00 / $37.00 / $37.00