go back

Pennsylvania rates for HCPCS J9203

Injection, gemtuzumab ozogamicin, 0.1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$238.98 / $369.13 / $719.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $286.31
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219.15 / $256.70 / $8,459.92
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.54 / $245.54 / $245.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.22 / $236.62 / $236.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $245.54
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.54 / $256.70 / $295.99
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$611.95 / $611.95 / $611.95
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$238.98 / $358.47 / $719.33
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $238.98 / $538.10
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.40 / $390.60 / $475.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.22 / $236.62 / $236.62
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $251.78
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$217.43 / $217.43 / $252.30
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.43 / $217.43 / $252.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $250.82 / $321.33