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Montana rates for HCPCS J9120

Injection, dactinomycin, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.34 / $357.89 / $410.42
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,003.62 / $68,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.19 / $354.19 / $3,255.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.34 / $328.34 / $464.63
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$328.34 / $397.29 / $1,652.60
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.34 / $406.00 / $1,048.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.34 / $328.34 / $328.34