go back

Utah rates for HCPCS J9203

Gemtuzumab ozogamicin 0.1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68.20 / $274.47 / $274.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $238.98 / $295.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$272.70 / $330.88 / $354.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $236.62
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $236.62 / $314.71
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$347.09 / $463.93 / $666.04
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.27 / $320.72 / $337.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $236.62