go back

Montana rates for HCPCS Q0138

Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-ESRD use)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,435.40 / $2,435.40 / $2,776.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $1,147.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.46 / $77,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.38 / $0.38 / $3.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.32 / $0.38
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.38 / $0.38 / $3.12
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.36 / $0.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.32 / $0.32