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Montana rates for HCPCS J7200

Injection, Factor IX, (antihemophilic factor, recombinant), Rixubis, per IU

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.84 / $1.90 / $3.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.86 / $1.86 / $4.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.69 / $1.69 / $1.86
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.86 / $1.86 / $4.28
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.69 / $1.83 / $2.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.69 / $1.69 / $1.69