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Tennessee rates for HCPCS J1190

Injection, dexrazoxane HCl, per 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.09 / $56.16 / $705.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.83 / $63.06 / $64.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$329.11 / $329.11 / $329.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.06 / $63.06 / $80.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $63.06 / $63.06
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.86 / $999.65 / $999.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $66.84 / $238.69