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Wisconsin rates for HCPCS J9118

Injection, calaspargase pegol-mknl, 10 units

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$84.54 / $163.82 / $245.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.08 / $82.90 / $95.21
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.60 / $151.83 / $183.02
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.08 / $82.08 / $110.80
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.33 / $147.74 / $150.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.07 / $116.37 / $212.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.30 / $97.45 / $129.16
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.91 / $82.51 / $90.76
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.87 / $164.16 / $164.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.91 / $81.91 / $91.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.91 / $91.18 / $337.90
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $65.00 / $186.73
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.91 / $82.08 / $91.35
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.87 / $164.16 / $164.16
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.08 / $118.62 / $256.10
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.98 / $82.07 / $337.90
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.07 / $140.79 / $337.90
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.24 / $115.24 / $115.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.08 / $84.55 / $97.68