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Ohio rates for HCPCS J9021

Injection Asparaginase Recombinant (Rylaze) 0.1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.47 / $120.37 / $184.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.30 / $55.47 / $70.16
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.91 / $95.13 / $158.09
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $62.12 / $93.52
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.47 / $55.47 / $83.21
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $55.47 / $74.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.33 / $54.38 / $55.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $55.47 / $70.34
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.14 / $83.92 / $200.19
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $55.47 / $78.50
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $59.81 / $61.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.47 / $55.47 / $55.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.38 / $55.47 / $64.17