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Kansas rates for HCPCS J9204

Injection, mogamulizumab-kpkc, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$253.47 / $281.32 / $1,093.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $268.38 / $347.90
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$254.32 / $273.72 / $288.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$256.95 / $256.95 / $256.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.43 / $248.50 / $265.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $248.50 / $248.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.50 / $265.08 / $379.21
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $276.63 / $1,074.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.34 / $248.34 / $248.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $263.41 / $295.72