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Utah rates for HCPCS J7503

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.12 / $2.13 / $87.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.85 / $2.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.11 / $2.52 / $2.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $1.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.58 / $1.83 / $30.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.48 / $2.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $1.83