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Montana rates for HCPCS J7321

Hyaluronan Or Derivative Hyalgan Supartz Or Visco-3 For Intra-Articular Injection Per Dose (Desc Rvsd 4/1/21)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$244.24 / $244.24 / $244.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.23 / $72.23 / $151.53
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$84.42 / $84.42 / $223.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.52 / $71.52 / $84.42
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$84.42 / $84.42 / $223.78
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.52 / $77.59 / $101.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.52 / $71.52 / $71.52