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Montana rates for HCPCS J3396

Injection, verteporfin, 0.1 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.53 / $11.65 / $1,711.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.15 / $13.15 / $33.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.54 / $11.54 / $13.15
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.15 / $13.15 / $33.08
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.54 / $12.51 / $16.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.54 / $11.54 / $11.54