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Wisconsin rates for HCPCS J0717

Injection Certolizumab Pegol 1 Mg (Code May Be Used For Medicare When Drug Administered Under Thedirect Supervision Of A Physician Not For Use When Drug Is Self Administered)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.03 / $8.98 / $9,832.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.91 / $5.36 / $8,160.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.88 / $7.23 / $8.72
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.91 / $3.91 / $4.96
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.35 / $5.35 / $6.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.91 / $4.98 / $12.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.05 / $7.51 / $8.53
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.91 / $4.49 / $8.56
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.74 / $7.82 / $7.82
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.49 / $4.49 / $9.98
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.49 / $4.49 / $7.82
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $65.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.91 / $4.49 / $8.56
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.74 / $7.82 / $7.82
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.91 / $6.09 / $13.58
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.00 / $85.00 / $85.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.91 / $3.91 / $3.91
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.49 / $5.49 / $12.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.91 / $3.91 / $8.21