go back

Arizona rates for HCPCS J1190

Injection, dexrazoxane HCl, per 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.52 / $126.12 / $229.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.83 / $69.37 / $523.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.18 / $208.35 / $412.06
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.36 / $31.06 / $401.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.06 / $63.06 / $63.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $63.06 / $63.06
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.29 / $50.46 / $339.39
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.09 / $32.09 / $35.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $63.06 / $63.06