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New Hampshire rates for HCPCS J9204

Injection, mogamulizumab-kpkc, 1 mg

Facilitymedian $398 · 10th–90th $251–$1,0000%10%10th90th$398Professionalmedian $251 · 10th–90th $251–$2950%50%90th$251$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
$251.19 / $281.84 / $501.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $295.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $660.69 / $1,096.48
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $275.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $501.19 / $676.08
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 / $309.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $398.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $251.19 / $269.15
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $234.42 / $257.04