go back

Montana rates for HCPCS J7202

Injection, Factor IX, albumin fusion protein, (recombinant), Idelvion, 1 IU

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.80 / $6.46 / $11.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.92 / $5.92 / $13.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.32 / $5.32 / $5.92
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.92 / $5.92 / $13.11
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.32 / $5.77 / $7.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.32 / $5.32 / $5.32