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Oregon rates for HCPCS J9204

Injection, mogamulizumab-kpkc, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $363.08 / $602.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $251.19 / $331.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $416.87 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $251.19 / $288.40
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $537.03 / $630.96
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $269.15 / $501.19
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $269.15 / $354.81
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $309.03 / $512.86
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $263.03 / $467.74
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $263.03 / $323.59
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $380.19 / $741.31
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $251.19 / $281.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $251.19 / $602.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $251.19 / $281.84