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Texas 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
$20.79 / $60.24 / $272.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.85 / $61.75 / $63.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.19 / $60.72 / $120.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.59 / $16.59 / $16.59
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.32 / $53.32 / $278.88
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.47 / $67.47 / $67.47
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
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $144.46 / $282.38
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.40 / $52.07 / $327.02
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.29 / $48.91 / $93.82
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.74 / $37.74 / $86.14
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.74 / $37.74 / $77.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.00 / $37.00 / $37.00
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.00 / $49.00 / $66.15