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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
$258.44 / $360.33 / $671.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $248.50 / $300.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.50 / $374.61 / $744.88
Anthem 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
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.33 / $257.87 / $297.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.08 / $248.50 / $273.35