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Nebraska rates for HCPCS J1190

Injection, dexrazoxane HCl, per 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.09 / $63.06 / $287.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.02 / $63.06 / $1,159.64
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.31 / $68.41 / $68.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.38 / $73.45 / $77.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $82.46 / $103.08
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.08 / $60.97 / $999.65
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.09 / $38.19 / $284.64
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.15 / $157.47 / $246.12
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.50 / $212.08 / $503.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $63.06 / $75.04