go back

Louisiana rates for HCPCS J9203

Injection, gemtuzumab ozogamicin, 0.1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$236.62 / $305.24 / $666.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $238.98 / $286.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.11 / $191.22 / $228.49
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$228.49 / $228.49 / $233.06
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$212.96 / $236.62 / $272.11