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Massachusetts rates for HCPCS J0207

Injection, amifostine, 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,092.83 / $1,092.83 / $2,571.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,028.55 / $1,092.83 / $1,092.83
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,135.69 / $1,461.53 / $5,678.45
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.41 / $1,135.69 / $4,885.62
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,309.34 / $1,499.89 / $2,914.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,092.83 / $1,092.83 / $1,092.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,092.83 / $1,092.83 / $1,092.83
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,135.69 / $1,135.69 / $1,135.69
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,244.38 / $5,678.45 / $5,678.45
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.41 / $1,135.69 / $4,885.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.41 / $1,124.98 / $1,318.50