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Montana rates for HCPCS J3486

Injection, ziprasidone mesylate, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $3.80 / $62.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.18 / $77,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.92 / $5.92 / $50.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.92 / $6.83 / $6.83
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.92 / $5.92 / $50.89
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.83 / $7.41 / $9.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.83 / $6.83 / $6.83