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Montana rates for HCPCS J7313

Injection Fluocinolone Acetonide Intravitreal Implant (Iluvien) 0.01 Mg (Desc Rvsd 10/1/19)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$542.97 / $602.34 / $1,286.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$560.22 / $560.22 / $1,450.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.14 / $498.14 / $560.22
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$560.22 / $560.22 / $1,450.32
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.14 / $540.42 / $704.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.14 / $498.14 / $498.14