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Kansas rates for HCPCS J0207

Injection, amifostine, 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $1,122.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,071.52 / $1,288.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $1,445.44 / $1,445.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,230.27 / $1,230.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,096.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,096.48
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.81 / $1,122.02 / $1,548.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,148.15 / $4,897.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $691.83 / $812.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,096.48 / $1,202.26