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Massachusetts rates for HCPCS J9204

Injection Mogamulizumab-Kpkc 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.50 / $337.22 / $490.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $248.50 / $298.20
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$216.39 / $665.98 / $1,242.50
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $248.50 / $1,074.29
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$266.39 / $305.16 / $592.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$243.32 / $248.50 / $248.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $248.50 / $248.50
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.50 / $392.63 / $8,090.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $248.50 / $248.50
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $248.50 / $287.61
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$330.55 / $1,242.50 / $1,242.50
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $263.41 / $1,074.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $248.50 / $372.75