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Pennsylvania rates for HCPCS J2562

Injection, plerixafor, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.58 / $279.56 / $509.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.33 / $25.58 / $957.06
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.36 / $27.48 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.29 / $26.29 / $26.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.90 / $25.33 / $25.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.33 / $25.33 / $25.33
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.66 / $293.20 / $365.10
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.33 / $120.66 / $363.19
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.90 / $25.33 / $25.33
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.33 / $25.33 / $25.33
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$401.92 / $401.92 / $466.38
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$401.92 / $401.92 / $466.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.33 / $26.85 / $46.35