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Nebraska 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 / $4.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $3.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.76 / $2.06 / $2.06
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.97 / $2.06 / $2.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $2.12 / $2.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.73 / $2.75 / $3.66
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.81 / $1.83 / $2.75
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.49 / $2.17 / $2.70
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.50 / $2.17 / $2.78
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.70 / $2.70 / $2.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.83 / $2.12