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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) (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.84 / $36.85 / $197.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.85 / $36.85 / $38.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.74 / $37.74 / $37.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.00 / $37.00 / $37.00