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Tennessee rates for HCPCS J9203

Injection, gemtuzumab ozogamicin, 0.1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $309.03 / $724.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $239.88 / $288.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $234.42 / $269.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $239.88 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $239.88 / $239.88
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $1,174.90 / $1,174.90
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $1,023.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.42 / $245.47 / $281.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $239.88 / $263.03