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Montana rates for HCPCS J9201

Injection Gemcitabine Hydrochloride Not Otherwise Specified 200 Mg (Desc Rvsd 1/1/20)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.09 / $119.07 / $367.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.13 / $3.58 / $84.60
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.40 / $68,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.65 / $3.65 / $11.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.13 / $3.13 / $4.43
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.13 / $4.91 / $178.38
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.17 / $3.65 / $4.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.13 / $3.13 / $3.13