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Montana rates for HCPCS Q4081

Injection, epoetin alfa, 100 units (for ESRD on dialysis)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.85 / $0.86 / $1.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.98 / $64,999.99 / $68,099.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.81 / $0.81 / $1.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.81 / $0.85 / $0.91
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.81 / $0.98 / $1.50
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.81 / $0.91 / $1.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.85 / $0.85 / $0.85