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Idaho rates for HCPCS J9203

Injection, gemtuzumab ozogamicin, 0.1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$236.62 / $236.62 / $272.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $243.71 / $295.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.22 / $223.22 / $236.62
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
$236.62 / $295.77 / $378.59
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $250.81 / $295.77
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.10 / $209.81 / $454.58
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$241.15 / $343.85 / $576.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$283.94 / $283.94 / $295.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $250.82