go back

Utah rates for HCPCS J1627

Injection, granisetron, extended-release, 0.1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.98 / $3.98 / $3.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $3.98 / $7.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.17 / $7.59 / $8.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.27 / $4.27 / $4.47
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.89 / $4.27 / $5.75
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.47 / $13.18 / $21.88
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.27 / $4.68 / $6.31
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.82 / $3.98 / $3.98
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.89 / $4.27 / $5.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.27 / $4.27 / $4.27