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Kentucky rates for HCPCS J9204

Injection, mogamulizumab-kpkc, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.50 / $248.50 / $422.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $248.50 / $300.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.32 / $293.04 / $497.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.17 / $248.50 / $248.50
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.50 / $298.20 / $397.60
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $273.35 / $382.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$243.63 / $243.63 / $248.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $248.50 / $338.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.63 / $248.50 / $316.72
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 / $276.63