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Minnesota 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 / $1.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.21
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.86 / $3.30
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.46 / $1.78 / $1.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.33 / $5.73 / $6.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.84 / $2.02 / $2.33
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.87 / $5.07 / $6.29
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.84 / $1.84 / $1.92
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.83 / $1.83 / $4.05
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $4.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.46