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California rates for HCPCS J9017

Injection, arsenic trioxide, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.15 / $13.16 / $57.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.09 / $8.23 / $15.70
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.15 / $8.15 / $8.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.68 / $13.02 / $29.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.86 / $8.15 / $40.94
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.79 / $34.36 / $78.14
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.31 / $8.73 / $26.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.69 / $7.69 / $8.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.15 / $8.15 / $11.54
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.68 / $4.79 / $6.32
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.34 / $9.77 / $21.76
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.44 / $547.94 / $608.45
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,072.56 / $7,072.56 / $7,072.56
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.68 / $9.59 / $60.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.15 / $9.00 / $54.64
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.15 / $8.15 / $23.13
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.27 / $39.27 / $39.27
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.52 / $8.15 / $12.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.15 / $8.23 / $16.63