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Wisconsin rates for HCPCS J8655

Netupitant 300 mg and palonosetron 0.5 mg, oral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.05 / $575.44 / $1,148.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $380.19 / $616.60
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.63 / $478.63 / $851.14
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $380.19 / $478.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $602.56 / $1,445.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $398.11 / $707.95
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $426.58 / $467.74
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $851.14 / $912.01
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $407.38 / $588.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $457.09 / $1,949.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $64.57 / $85.11
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $660.69 / $1,258.93
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $380.19 / $2,137.96
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $501.19 / $1,949.84
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $537.03 / $660.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $407.38 / $407.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $407.38 / $457.09