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Wisconsin rates for HCPCS J1448

Injection Trilaciclib 1mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.55 / $10.51 / $12.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.46 / $5.63 / $9.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.83 / $10.10 / $12.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.46 / $5.46 / $6.93
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.08 / $8.74 / $10.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.46 / $13.05 / $18.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.48 / $8.11 / $9.21
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.39 / $5.39 / $12.13
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.09 / $10.92 / $10.92
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.39 / $5.39 / $12.13
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.39 / $6.00 / $10.92
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.39 / $5.39 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.39 / $5.39 / $12.13
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.09 / $10.92 / $10.92
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.46 / $8.35 / $18.37
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.46 / $5.46 / $85.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.46 / $5.46 / $5.46
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.67 / $7.67 / $7.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.46 / $6.08 / $7.64