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Missouri rates for HCPCS J9204

Injection, mogamulizumab-kpkc, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $288.40 / $933.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $257.04 / $371.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $269.15 / $891.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $251.19 / $309.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $281.84 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $251.19 / $251.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $251.19 / $263.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $281.84 / $467.74
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $263.03 / $1,071.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $295.12 / $323.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $251.19 / $288.40