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Utah rates for HCPCS J1190

Injection, dexrazoxane HCl, per 250 mg

Facilitymedian $78 · 10th–90th $65–$4370%20%10th90th$78Professionalmedian $58 · 10th–90th $51–$1020%20%40%10th90th$58$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $436.52
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $67.61 / $102.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $89.13 / $177.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $50.12
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $75.86 / $309.03
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $51.29
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $50.12 / $165.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $64.57