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Montana rates for HCPCS J9050

Carmustine 100 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$210.10 / $238.46 / $298.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$178.57 / $178.57 / $5,832.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$178.57 / $238.46 / $337.44
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$176.11 / $238.46 / $3,355.28
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.46 / $337.44 / $512.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.46 / $238.46 / $238.46