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North Dakota 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 / $425.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $286.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$256.70 / $257.99 / $261.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.97 / $257.99 / $261.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $237.53 / $301.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$221.84 / $260.27 / $425.92
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $263.41 / $1,029.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $263.41 / $295.02