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Alaska rates for HCPCS J9203

Injection, gemtuzumab ozogamicin, 0.1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$246.24 / $435.71 / $1,540.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.49 / $260.27 / $440.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $236.62
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$238.98 / $440.11 / $616.15
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $473.24
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$351.87 / $369.47 / $580.60
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.91 / $316.69 / $316.69
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$236.62 / $440.11 / $616.15
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $275.62 / $312.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$250.82 / $354.93 / $709.86