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Iowa rates for HCPCS J9204

Injection, mogamulizumab-kpkc, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.32 / $281.32 / $546.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $248.50 / $534.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.21 / $269.60 / $357.79
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $354.85 / $525.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.50 / $281.32 / $432.56
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $276.63 / $1,074.29
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$292.35 / $372.75 / $491.76
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.35 / $316.31 / $538.76
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$253.47 / $492.44 / $519.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $255.96 / $295.72
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$271.94 / $271.94 / $271.94
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$214.83 / $271.94 / $271.94