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Pennsylvania rates for HCPCS J9021

Injection Asparaginase Recombinant (Rylaze) 0.1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.85 / $129.40 / $168.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $55.47 / $61.02
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.38 / $60.18 / $8,459.92
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.57 / $57.57 / $57.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.33 / $55.47 / $55.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $55.47 / $57.57
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $55.47 / $69.39
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$146.16 / $146.16 / $146.16
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.85 / $117.24 / $20,940.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $55.85 / $94.39
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.40 / $27.40 / $83.21
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.33 / $55.47 / $55.47
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $55.47 / $58.71
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.08 / $48.08 / $55.79
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.08 / $48.08 / $55.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.47 / $55.47 / $55.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $58.80 / $74.88