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Oregon rates for HCPCS J1190

Injection, dexrazoxane HCl, per 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $91.20 / $151.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $60.26 / $107.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $138.04 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $57.54 / $63.10
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $97.72 / $114.82
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $61.66 / $144.54
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $63.10 / $204.17
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.10 / $79.43 / $154.88
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $138.04 / $295.12
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $69.18 / $158.49
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $257.04 / $588.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $57.54 / $138.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $57.54 / $64.57