go back

Hawaii rates for HCPCS J9203

Injection, gemtuzumab ozogamicin, 0.1 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $239.88 / $281.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $239.88 / $269.15
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $223.87
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $288.40 / $363.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $245.47 / $281.84