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Maryland 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 / $31.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.73
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $1.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.00 / $85.00 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.16
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.56 / $1.83 / $1.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.81 / $1.83 / $1.93
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.80 / $1.80 / $2.47