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Indiana rates for HCPCS J9120

Injection, dactinomycin, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.03 / $645.65 / $1,412.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $309.03 / $416.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $457.09 / $676.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $309.03 / $489.78
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $398.11 / $588.84
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $331.13 / $331.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.03 / $309.03 / $426.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $309.03 / $436.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $331.13 / $575.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $323.59 / $354.81