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New Jersey rates for HCPCS C9064

Mitomycin pyelocalyceal instillation, 1 mg

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $281.84 / $338.84
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.90 / $11,481.54 / $25,703.96
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $275.42 / $275.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $354.81 / $354.81