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Montana rates for HCPCS J9021

Injection Asparaginase Recombinant (Rylaze) 0.1 Mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $56.03 / $66.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $77,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.69 / $66.69 / $66.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $55.47 / $66.69
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.47 / $62.14 / $67.68
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $65.98 / $70.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $55.47 / $55.47