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Vermont rates for HCPCS J3101

Injection Tenecteplase 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.22 / $172.22 / $295.39
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.97 / $194.97 / $194.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.47 / $183.91 / $306.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.22 / $172.22 / $172.22
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.47 / $183.91 / $306.52
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.22 / $172.22 / $172.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.61 / $172.22 / $264.93