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Georgia rates for HCPCS J9204

Injection, mogamulizumab-kpkc, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.50 / $248.50 / $514.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $248.50 / $295.72
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.50 / $397.60 / $912.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $248.50 / $253.47
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.50 / $248.50 / $487.06
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $248.50 / $248.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.43 / $234.43 / $248.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $248.50 / $293.04
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.87 / $291.98 / $531.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.07 / $422.44 / $511.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $263.41 / $310.63