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Pennsylvania rates for HCPCS J9177

Injection, enfortumab vedotin-ejfv, 0.25 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.03 / $85.78 / $32,436.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.74 / $36.74 / $47.03
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.74 / $36.74 / $36.74
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.03 / $39.86 / $8,459.92
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.13 / $38.13 / $38.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.65 / $36.74 / $36.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.74 / $36.74 / $38.13
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.13 / $38.13 / $45.96
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.15 / $82.50 / $107.28
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.03 / $79.92 / $19,337.40
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.74 / $37.11 / $111.45
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.40 / $55.11 / $67.90
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.65 / $36.74 / $36.74
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.74 / $36.74 / $39.59
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.57 / $32.57 / $37.79
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.57 / $32.57 / $37.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.74 / $38.94 / $47.95