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Ohio rates for HCPCS J9204

Injection, mogamulizumab-kpkc, 1 mg

Facilitymedian $447 · 10th–90th $251–$7080%20%10th90th$447Professionalmedian $251 · 10th–90th $251–$3800%50%90th$251$5.0$20.0$100.0$500.0$2.0K$10.0K

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 / $467.74 / $707.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $331.13
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $467.74 / $1,318.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $288.40 / $446.68
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $338.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $501.19 / $831.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $302.00
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $251.19 / $371.54
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $354.81
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $281.84 / $363.08
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $281.84 / $478.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $524.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $251.19 / $281.84