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Vermont rates for HCPCS J9295

Injection Necitumumab 1 Mg (Reinstated 01/01/2017). Polyestradiol Phosphate 40 Mg (Del 03/31/2003).

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.73 / $5.73 / $15.01
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.49 / $6.49 / $6.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.41 / $6.49 / $10.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.73 / $5.73 / $10.81
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.41 / $6.49 / $10.81
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.73 / $5.73 / $10.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.52 / $6.07 / $13.26