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Nebraska 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 / $523.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $397.10
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.20 / $256.70 / $256.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.68 / $290.19 / $290.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $334.85 / $359.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$226.28 / $343.10 / $461.41
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$233.12 / $259.51 / $354.93
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$279.74 / $349.68 / $475.19
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$279.74 / $349.68 / $379.56
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.83 / $333.00 / $489.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $281.58