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Indiana rates for HCPCS J9173

Injection, durvalumab, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.10 / $239.88 / $24,547.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $87.10 / $117.49
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $87.10
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.33 / $128.82 / $190.55
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $128.82
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $85.11 / $128.82
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $85.11 / $131.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.10 / $87.10 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $102.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $85.11 / $165.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $91.20 / $95.50