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Idaho rates for HCPCS J9021

Injection Asparaginase Recombinant (Rylaze) 0.1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.30 / $55.30 / $63.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.30 / $57.14 / $69.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.33 / $52.33 / $55.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $55.47 / $55.47
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.30 / $69.34 / $88.76
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $58.80 / $69.34
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $95.17 / $106.04
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.48 / $76.77 / $131.50
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.56 / $66.56 / $69.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $55.47 / $58.80