go back

Virginia rates for HCPCS J7503

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.92 / $3.84 / $40.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.45
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $1.83
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 / $1.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.56 / $1.83 / $2.20
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.23 / $1.92 / $2.93
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.78 / $2.00 / $4.15
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.83 / $2.09 / $2.75
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $2.09 / $2.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.80 / $1.83 / $1.92