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Utah 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
$25.12 / $36.31 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $36.31 / $60.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.70 / $25.70 / $25.70
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $89.13 / $89.13
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.44 / $24.55 / $28.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $46.77 / $48.98