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Montana rates for HCPCS J9274

Injection, tebentafusp-tebn, 1 mcg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50,974.16 / $50,974.16 / $50,974.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.09 / $219.26 / $262.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.38 / $263.38 / $263.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.09 / $217.09 / $263.38
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$217.09 / $254.79 / $268.45
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$224.21 / $263.38 / $276.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.09 / $217.09 / $217.09