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Louisiana rates for HCPCS J7503

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.56 / $1.89 / $4.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.21
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.59 / $0.70 / $1.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.99 / $1.99 / $2.02
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.68 / $1.83 / $2.02