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Georgia rates for HCPCS J9204

Injection, mogamulizumab-kpkc, 1 mg

Facilitymedian $417 · 10th–90th $251–$1,2590%20%40%10th90th$417Professionalmedian $251 · 10th–90th $251–$2950%50%90th$251$1.0$5.0$20.0$100.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $288.40 / $537.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $302.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $933.25 / $1,380.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $467.74 / $676.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $295.12
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $288.40 / $524.81
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $251.19 / $478.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $478.63 / $676.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $251.19 / $302.00