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Michigan rates for HCPCS J7503

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.89 / $3.00 / $3.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.85 / $2.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.18 / $4.07 / $7.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.77 / $1.93 / $2.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.16
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.83 / $3.00 / $5.26
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.85 / $2.22
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $75.00 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $1.97