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Vermont rates for HCPCS J3105

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.71 / $7.39 / $8.19
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.36 / $8.36 / $8.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.60 / $2.67 / $6.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.39 / $7.39 / $7.39
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.60 / $2.67 / $6.97
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.39 / $7.39 / $7.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.02 / $7.39 / $11.37