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Ohio 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 / $3.97 / $12.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.34
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.75 / $4.07 / $11.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $2.04 / $3.08
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.92
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.73 / $1.73 / $1.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.33
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.10 / $3.28 / $85.00
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.59
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.81 / $2.08 / $2.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.12