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Montana rates for HCPCS J7177

Injection, human fibrinogen concentrate (Fibryga), 1 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.22 / $1.46 / $1.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.27 / $1.27 / $3.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.23 / $1.27
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.27 / $1.27 / $3.52
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.33 / $1.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.23 / $1.23