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New York 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 / $2.31 / $4.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.14
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.67 / $1.83 / $2.14
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.51 / $1.51 / $1.59
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.51 / $1.51 / $1.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.52 / $1.73 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $1.99
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.99 / $2.85 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.90 / $1.99 / $2.23
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.83 / $1.83 / $1.90
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.90 / $1.90
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.29 / $2.29 / $2.29
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.52 / $1.73 / $85.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $227.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.56
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.90 / $1.90 / $1.90
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.90 / $1.90