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Michigan rates for HCPCS J9021

Injection Asparaginase Recombinant (Rylaze) 0.1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.96 / $74.05 / $110.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $56.03 / $61.02
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.43 / $120.97 / $230.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.68 / $58.77 / $76.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $55.47 / $70.34
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.47 / $110.60 / $158.49
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $56.58 / $67.02
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $55.47 / $74.65
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.47 / $55.47 / $55.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.38 / $60.54 / $67.12