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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
$239.88 / $363.08 / $478.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $239.88 / $398.11
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.98 / $245.47 / $263.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $288.40 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $281.84 / $363.08
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $295.12 / $457.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $263.03 / $1,023.29
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $346.74 / $363.08
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $363.08 / $588.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $239.88 / $467.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $239.88 / $288.40