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Montana rates for HCPCS J3260

Injection, tobramycin sulfate, up to 80 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.82 / $20.43 / $70.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.37 / $2.39 / $9.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.82 / $1.82 / $10.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.82 / $2.37 / $2.37
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.82 / $1.82 / $10.19
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.37 / $2.58 / $3.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.37 / $2.37 / $2.37