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Montana rates for HCPCS J9302

Injection Ofatumumab 10 Mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.92 / $60.09 / $162.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$105.13 / $326.00 / $326.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.54 / $61.54 / $326.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.40 / $64.50 / $326.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.54 / $75.43 / $139.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.34 / $60.34 / $60.34