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Mitomycin Pyelocalyceal Instillation (Jelmyto)

New Jersey rates for HCPCS C9064

Mitomycin pyelocalyceal instillation, 1 mg

Rates data updated July 2026.

How much does Mitomycin Pyelocalyceal Instillation (Jelmyto) cost?

$275per mg

Typical physician fee. In New Jersey, July 2026.

Insurers have agreed to pay about $275 for each mg of this drug. Most negotiated rates run $275 to $275.

Work out the cost of a dose

This drug is priced per mg. Enter the amount given to see what insurers have agreed to pay for it.

mg
In a doctor's office or clinic
$275

Drug cost only. Giving the drug, the visit itself and any monitoring are billed on their own codes. We do not publish dosing guidance: use the amount from your own prescription or treatment plan.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 3 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $11,482 · 10th to 90th $135 to $25,119Professionalmedian $275 · 10th to 90th $275 to $275
$100$500$2K$10Kfacility $11,482professional $275

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Cigna
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$338.84
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$11,481.54
Typical High
$25,118.86
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$354.81
Typical High
$354.81

Where New Jersey sits

The same service costs 45.7 times more in Tennessee than in South Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

New Jersey· 36th of 42

$275

TN $1,380SC $30.20

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.