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Idaho rates for HCPCS J9204

Injection, mogamulizumab-kpkc, 1 mg

Facilitymedian $295 · 10th–90th $251–$4470%20%40%10th90th$295Professionalmedian $257 · 10th–90th $251–$3160%50%10th90th$257$50.0$100.0$200.0$500.0$1.0K

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 / $416.87 / $416.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $257.04 / $323.59
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $354.81 / $602.56
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $645.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $269.15 / $398.11
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $269.15 / $346.74
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $177.83 / $208.93
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $354.81 / $588.84
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $302.00 / $302.00
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $263.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $251.19 / $269.15