go back

Vermont rates for HCPCS J9021

Injection Asparaginase Recombinant (Rylaze) 0.1 Mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $55.47 / $66.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.80 / $62.80 / $62.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.33 / $61.56 / $102.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $55.47 / $102.60
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.33 / $61.56 / $102.60
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $55.47 / $102.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.16 / $58.80 / $128.16