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Utah rates for HCPCS J0717

Injection, certolizumab pegol, 1 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.98 / $457.09 / $457.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $3.02 / $3.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.57 / $5.75 / $7.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.89 / $3.89 / $3.89
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.69 / $10.72 / $19.05
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $11.48 / $11.48
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.55 / $3.89 / $4.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.89 / $3.89 / $3.89