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West 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
$1.83 / $1.83 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $1.92
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.83 / $2.00 / $2.75
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.19 / $1.83 / $4.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.73 / $85.00 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $1.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.02 / $3.02 / $3.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $2.12