go back

Montana rates for HCPCS J7505

Muromonab-CD3, parenteral, 5 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$775.20 / $1,011.28 / $1,086.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,411.77 / $1,411.77 / $1,411.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,411.77 / $1,411.77 / $1,523.52
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$868.98 / $1,156.08 / $1,411.77
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,411.77 / $1,411.77 / $2,400,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,308.77 / $1,308.77 / $1,308.77