go back

Alabama rates for HCPCS J9204

Injection, mogamulizumab-kpkc, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.50 / $248.50 / $248.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $248.50 / $298.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,863.89 / $8,329.65 / $11,206.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $248.50 / $248.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.50 / $248.50 / $248.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $248.50 / $248.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$211.23 / $248.50 / $270.87