go back

Wisconsin rates for HCPCS J9177

Injection, enfortumab vedotin-ejfv, 0.25 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.02 / $74.13 / $44,668.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $37.15 / $66.07
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.71 / $45.71 / $81.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $36.31 / $46.77
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.15 / $50.12 / $69.18
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.15 / $40.74 / $85.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $56.23 / $131.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $38.02 / $67.61
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.15 / $37.15 / $40.74
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $74.13 / $77.62
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.31 / $36.31 / $41.69
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $40.74 / $162.18
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $64.57 / $85.11
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $57.54 / $112.20
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $36.31 / $181.97
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $61.66 / $162.18
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $50.12 / $60.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.31 / $36.31 / $36.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $38.90 / $41.69