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Montana rates for HCPCS J9209

Mesna 200 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.61 / $1.86 / $5.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.22 / $68,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.04 / $1.66 / $1.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $1.86 / $2.47
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.66 / $2.04 / $11.50
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.67 / $2.20 / $2.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.86 / $1.86 / $1.86