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Hawaii rates for HCPCS J7503

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.12 / $3.12 / $3.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.13 / $3.13 / $3.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.16
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.63 / $2.63 / $2.63
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $2.20 / $2.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.75