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Michigan rates for HCPCS J9203

Injection, gemtuzumab ozogamicin, 0.1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$243.71 / $316.82 / $473.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $238.98 / $260.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$274.88 / $516.08 / $983.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.03 / $250.72 / $325.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $279.74
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$236.62 / $426.49 / $678.12
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $243.71 / $295.77
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$233.12 / $256.43 / $349.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $263.41 / $286.31