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Maryland rates for HCPCS J9017

Injection, arsenic trioxide, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.41 / $7.41 / $14.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.08 / $14.45
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.41 / $7.41 / $7.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.68 / $4.68 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.41 / $7.41 / $7.59
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.31 / $7.41 / $41.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.37 / $5.37 / $7.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.37 / $7.76 / $8.71
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.68 / $4.68 / $9.77