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Connecticut rates for HCPCS J9204

Injection, mogamulizumab-kpkc, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.84 / $436.52 / $741.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $251.19 / $309.03
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $389.05 / $602.56
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $251.19 / $263.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $251.19 / $251.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $251.19 / $251.19
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $263.03 / $302.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $251.19 / $281.84