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Idaho rates for HCPCS J3105

Injection Terbutaline Sulfate Up To 1 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.74 / $12.42 / $83.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.74 / $8.06 / $9.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.97 / $7.39 / $7.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.39 / $7.39 / $7.39
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.13 / $10.41 / $28.78
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.39 / $7.39 / $9.24
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.86 / $8.86 / $9.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.39 / $7.39 / $9.66