go back

Utah rates for HCPCS J9021

Injection Asparaginase Recombinant (Rylaze) 0.1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.34 / $23,989.35 / $38,239.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $55.47 / $64.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.34 / $74.51 / $82.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $55.47 / $55.47
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $45.00 / $60.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.80 / $106.25 / $152.54
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.02 / $75.19 / $79.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $55.47 / $55.47