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Utah rates for HCPCS J0202

Lemtrada IV SOLN 12 MG/1.2ML

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,818.67 / $2,818.67 / $2,818.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,429.89 / $2,454.19 / $3,037.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,823.17 / $3,187.45 / $3,665.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,429.89 / $2,429.89 / $2,429.89
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,708.49 / $2,441.48 / $3,173.93
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,805.12 / $4,885.59 / $6,811.64
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,672.88 / $3,293.52 / $3,466.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,429.89 / $2,429.89 / $2,429.89