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Utah rates for HCPCS J9040

Bleomycin Sulfate 15 Units (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.97 / $58.69 / $192.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.53 / $23.12 / $70.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.47 / $30.74 / $31.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.52 / $21.52 / $21.52
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.90 / $26.16 / $39.19
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.68 / $29.18 / $30.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.53 / $21.53 / $21.53