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Idaho rates for HCPCS J9017

Arsenic Trioxide IV SOLN 10 MG/10ML

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.86 / $5.86 / $2,638.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.92 / $8.23 / $10.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.69 / $7.69 / $8.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.15 / $8.15 / $8.15
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.86 / $11.48 / $47.84
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.15 / $8.97 / $10.60
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.58 / $8.38 / $14.20
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.76 / $19.46 / $35.75
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.77 / $9.77 / $10.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.15 / $8.15 / $13.04