go back

Utah rates for HCPCS J7340

Carbidopa 5 Mg/Levodopa 20 Mg Enteral Suspension 100 Ml (Desc Revised 01/01/2017) Dermal And Epidermal (Substitute) Tissue Of Humanorigin With Or Without Bioengineered Or Processed Elements With Metabolically Active Elements Per Square Centimeter (Del 12/31/08)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$282.05 / $282.58 / $282.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.97 / $282.58 / $304.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$243.61 / $311.63 / $358.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$240.23 / $243.61 / $243.61
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $193.33 / $243.15
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.54 / $474.50 / $681.21
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.97 / $267.97 / $292.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.61 / $243.61 / $243.61