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Virginia rates for HCPCS J1190

Injection, dexrazoxane HCl, per 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.06 / $67.38 / $1,873.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $66.20 / $70.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.06 / $133.06 / $214.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $63.06 / $63.06
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.71 / $156.69 / $236.48
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 / $63.06
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.60 / $75.67 / $280.81
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.06 / $287.97 / $349.23
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.00 / $181.00 / $181.00
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.91 / $76.30 / $312.64
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.91 / $76.30 / $312.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $66.84 / $81.98