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Indiana rates for HCPCS J7503

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.85 / $4.25 / $12.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.92 / $3.66 / $5.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.52
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.75
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.83 / $1.83 / $1.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $1.96