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New Mexico rates for HCPCS J9120

Injection, dactinomycin, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$472.25 / $472.25 / $472.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.34 / $328.34 / $424.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,521.41 / $6,213.56 / $10,437.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$328.34 / $328.34 / $752.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.34 / $328.34 / $328.34
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$470.74 / $838.46 / $1,257.69
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.50 / $331.62 / $678.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.34 / $328.34 / $505.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.34 / $328.34 / $348.04