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Washington rates for HCPCS J9021

Injection Asparaginase Recombinant (Rylaze) 0.1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.18 / $61.02 / $59,515.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $56.03 / $66.91
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.96 / $78.90 / $271.89
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $61.02 / $239.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.33 / $54.14 / $108.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $55.47 / $68.03
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.53 / $69.34 / $131.22
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.02 / $68.00 / $119.42
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.38 / $60.83 / $75.00
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.60 / $55.47 / $93.12
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.22 / $77.95 / $142.68
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.20 / $68.95 / $124.64
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.60 / $61.91 / $112.60
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $61.02 / $66.56
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 / $55.47 / $66.56
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.14 / $55.47 / $55.47