go back

Utah rates for HCPCS J9120

Injection, dactinomycin, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.87 / $380.87 / $1,808.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.34 / $331.62 / $410.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$379.96 / $428.99 / $687.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.34 / $328.34 / $328.34
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.16 / $346.56 / $1,622.72
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$643.97 / $854.65 / $1,296.69
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$361.17 / $445.04 / $468.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.34 / $328.34 / $328.34