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Wisconsin rates for HCPCS J3241

Injection, teprotumumab-trbw, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $549.54 / $72,443.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $371.54 / $912.01
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $457.09 / $831.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $371.54 / $467.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $380.19 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $467.74 / $676.08
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $363.08 / $794.33
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $724.44 / $724.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $363.08 / $794.33
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $363.08 / $575.44
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $85.11 / $85.11
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $371.54 / $1,174.90
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$346.74 / $371.54 / $1,778.28
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $371.54 / $371.54
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $501.19 / $616.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $354.81 / $371.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $371.54 / $501.19