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Idaho rates for HCPCS J3260

Injection Tobramycin Sulfate Up To 80 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.46 / $3.41 / $142.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.37 / $2.46 / $2.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.24 / $2.37 / $2.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.37 / $2.37 / $2.37
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.61 / $3.15 / $4.51
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.37 / $2.37 / $2.96
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.85 / $2.85 / $2.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.37 / $2.37 / $3.32