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Montana rates for HCPCS J8655

Netupitant 300 mg and palonosetron 0.5 mg, oral

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$422.89 / $460.95 / $528.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$401.23 / $466.89 / $697.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$422.89 / $422.89 / $466.89
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$422.89 / $466.89 / $558.22
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$422.89 / $480.30 / $509.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$422.89 / $422.89 / $422.89