go back

Montana rates for HCPCS Q0139

Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (for ESRD on dialysis)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.32 / $0.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.38 / $0.38 / $1.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.32 / $0.46
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.32 / $0.38 / $0.93
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.36 / $0.43 / $0.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.32 / $0.32