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Pennsylvania rates for HCPCS J9173

Inj., durvalumab, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86.10 / $10,673.46 / $30,614.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.12 / $85.96 / $123.42
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.25 / $85.25 / $85.25
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.84 / $92.35 / $8,459.92
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.33 / $88.33 / $88.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.30 / $85.12 / $85.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.12 / $85.12 / $88.33
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.33 / $92.35 / $106.48
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.71 / $181.18 / $258.45
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.80 / $93.80 / $93.80
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86.10 / $219.95 / $30,988.62
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.12 / $86.10 / $209.72
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.40 / $142.19 / $172.90
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.30 / $85.12 / $85.12
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.12 / $85.12 / $90.59
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.90 / $78.90 / $91.56
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.90 / $78.90 / $91.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.12 / $90.23 / $113.71