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Arizona rates for HCPCS J7503

Tacrolimus, extended release, (Envarsus XR), oral, 0.25 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.69 / $3.47 / $22.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $2.45
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.58 / $3.89 / $7.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.51 / $2.00 / $3.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.86 / $1.86 / $1.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.86 / $1.86 / $1.86
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.82 / $2.04 / $3.31
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.82 / $1.82 / $549.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.45 / $3.02 / $3.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.82 / $1.86 / $1.86