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Utah rates for HCPCS J9100

Injection, cytarabine, 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.44 / $23.99 / $257.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.41 / $3.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.93 / $1.17 / $1.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.83 / $0.83 / $0.91
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $1.00 / $1.29
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.91 / $0.91 / $1.23
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.58 / $0.83 / $0.83
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.83 / $1.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.83 / $0.83 / $0.83