go back

Texas rates for HCPCS J1190

Injection, dexrazoxane HCl, per 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.51 / $70.01 / $1,593.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.98 / $63.06 / $69.37
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$214.20 / $511.81 / $1,091.86
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.01 / $174.01 / $174.01
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$888.89 / $888.89 / $888.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.49 / $63.06 / $63.06
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
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.09 / $91.08 / $237.99
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.07 / $63.06 / $311.70
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.49 / $63.06 / $222.49
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.79 / $63.06 / $146.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $70.20 / $70.20
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.09 / $80.88 / $85.13