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Minnesota rates for HCPCS J9204

Injection Mogamulizumab-Kpkc 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.50 / $248.50 / $248.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $248.50 / $300.69
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$215.67 / $238.85 / $503.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.74 / $253.09 / $260.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$450.47 / $775.19 / $943.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $273.02 / $315.23
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$388.56 / $685.34 / $850.45
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.21 / $248.21 / $259.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.50 / $248.50 / $547.45
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $276.63 / $639.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $261.37 / $460.72