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Michigan rates for HCPCS J1454

Injection, fosnetupitant 235 mg and palonosetron 0.25 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$592.77 / $624.54 / $1,948.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.50 / $587.01 / $725.12
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,125.75 / $1,125.75 / $1,125.75
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$668.57 / $1,255.22 / $2,391.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$548.86 / $600.86 / $779.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.50 / $575.50 / $732.95
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.50 / $1,212.70 / $1,737.78
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.50 / $592.77 / $734.90
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.50 / $633.04 / $886.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.50 / $640.65 / $713.68