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Montana rates for HCPCS J7311

Injection, fluocinolone acetonide, intravitreal implant (Retisert), 0.01 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$370.94 / $411.11 / $892.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$361.11 / $388.16 / $1,008.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$340.31 / $388.16 / $388.16
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$340.31 / $388.16 / $1,945.40
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$369.21 / $369.21 / $433.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$340.31 / $340.31 / $340.31