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Indiana rates for HCPCS J9203

Injection, gemtuzumab ozogamicin, 0.1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$238.98 / $551.21 / $1,638.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $260.27
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$236.62 / $473.24 / $572.62
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $326.52
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$236.62 / $260.27 / $354.93
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $260.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$236.62 / $236.62 / $236.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $267.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $250.82 / $283.94