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Montana rates for HCPCS J7208

Injection, Factor VIII, (antihemophilic factor, recombinant), PEGylated-aucl, (Jivi), 1 IU

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.88 / $3.21 / $5.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.78 / $2.78 / $5.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.65 / $2.65 / $2.78
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.78 / $2.78 / $5.96
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.65 / $2.88 / $3.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.65 / $2.65 / $2.65