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Pennsylvania rates for HCPCS J9204

Injection, mogamulizumab-kpkc, 1 mg

Facilitymedian $490 · 10th–90th $257–$7760%20%10th90th$490Professionalmedian $251 · 10th–90th $251–$3310%50%90th$251$1.0$10.0$100.0$1.0K$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
$257.04 / $489.78 / $776.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $257.04 / $338.84
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $275.42 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $263.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $426.58 / $954.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $309.03
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $251.19 / $251.19
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $275.42 / $446.68
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $489.78 / $676.08
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $295.12
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $30.20 / $478.63
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $288.40 / $309.03
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $288.40 / $309.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $251.19 / $295.12