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Oklahoma rates for HCPCS J9017

Injection, arsenic trioxide, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.15 / $6.33 / $12.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.15 / $8.23 / $9.77
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $7.85 / $7.85
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.35 / $96.78 / $153.44
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 / $8.15
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.92 / $7.28 / $70.55
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.98 / $6.21 / $7,072.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.15 / $8.15 / $9.69