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New Mexico rates for HCPCS J7503

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.04 / $2.88 / $5.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $2.19
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56,234.13 / $69,183.10 / $81,283.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.62 / $1.62 / $2.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.86 / $1.86 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.86 / $1.86 / $1.86
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.82 / $2.00 / $3.89
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.66 / $1.91 / $3.09
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.86 / $1.86 / $2.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.86 / $1.86 / $1.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.82 / $1.86 / $1.86