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Montana rates for HCPCS J9210

Injection, emapalumab-lzsg, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $380.19 / $1,047.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $467.74 / $467.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $380.19 / $467.74
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.05 / $398.11 / $1,148.15
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $398.11 / $1,148.15
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $467.74 / $467.74
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $380.19 / $549.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $380.19 / $380.19