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Montana rates for HCPCS J9042

Injection, brentuximab vedotin, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$258.63 / $261.23 / $326.38
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.08 / $68,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$294.16 / $294.16 / $519.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$258.64 / $258.64 / $294.16
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$258.64 / $294.16 / $341.40
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$258.64 / $294.16 / $329.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$258.64 / $258.64 / $258.64