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Oklahoma rates for HCPCS J1190

Injection, dexrazoxane HCl, per 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.69 / $34.65 / $68.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.09 / $68.09 / $70.05
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.70 / $193.51 / $306.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.49 / $59.49 / $63.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $63.06 / $222.49
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.08 / $49.55 / $287.97
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.09 / $34.02 / $80.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $63.06 / $70.20