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Idaho rates for HCPCS J7503

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.89 / $2.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.73 / $1.73 / $1.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $1.83
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.83 / $2.29 / $2.93
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.94 / $2.29
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.33 / $2.81 / $3.53
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.20 / $2.20 / $2.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $1.83