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Cladribine Injection

Vermont rates for HCPCS J9065

Injection, cladribine, per 1 mg

Rates data updated July 2026.

How much does Cladribine Injection cost?

$8.71per mg

Typical negotiated rate. In Vermont, July 2026.

Insurers have agreed to pay about $8.71 for each mg of this drug. The price depends on where it is billed: about $8.71 from a physician practice, and about $12.02 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

Work out the cost of a dose

This drug is priced per mg. Enter the amount given to see what insurers have agreed to pay for it.

mg
In a doctor's office or clinic
$8.71
At a hospital outpatient department
$12.02

The same drug, in the same amount, costs 38% more at a hospital than at a doctor's office.

Drug cost only. Giving the drug, the visit itself and any monitoring are billed on their own codes. We do not publish dosing guidance: use the amount from your own prescription or treatment plan.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$8.71$8.71 to $9.33
FacilityA hospital or hospital-owned outpatient department$12.02$12.02 to $12.02

How much rates vary

Facilitymedian $12 · 10th to 90th $10 to $12Professionalmedian $9 · 10th to 90th $9 to $12
$10$20facility $12professional $9

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$8.71
Median
$8.71
Typical High
$12.02
BCBS
Setting
Facility
Modifier
Global
Typical Low
$12.02
Median
$12.02
Typical High
$12.02
Cigna
Setting
Facility
Modifier
Global
Typical Low
$9.77
Median
$12.02
Typical High
$12.02
Cigna
Setting
Professional
Modifier
Global
Typical Low
$8.71
Median
$8.71
Typical High
$12.02
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$18.20
Median
$18.20
Typical High
$31.62
United
Setting
Facility
Modifier
Global
Typical Low
$8.32
Median
$8.32
Typical High
$8.32
United
Setting
Professional
Modifier
Global
Typical Low
$7.41
Median
$8.71
Typical High
$22.39

Where Vermont sits

Rates are fairly even across states for this service. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Vermont· 50th of 51

$8.71

NY $12.30MS $8.71

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.