go back

North Carolina rates for HCPCS J9204

Injection, mogamulizumab-kpkc, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $302.00 / $29,512.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $251.19 / $309.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.42 / $407.38 / $512.86
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $269.15 / $295.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $251.19 / $371.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $251.19 / $288.40
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $251.19 / $389.05
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $338.84 / $398.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $398.11 / $446.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $269.15 / $281.84
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,230.27 / $1,230.27
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,071.52 / $1,071.52