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Maine rates for HCPCS J9204

Injection, mogamulizumab-kpkc, 1 mg

Facilitymedian $631 · 10th–90th $309–$6310%50%10th$631Professionalmedian $251 · 10th–90th $251–$3020%50%90th$251$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
$588.84 / $630.96 / $630.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $338.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $295.12 / $794.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $263.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $354.81 / $724.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
Martin's Point
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
$223.87 / $251.19 / $316.23