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Tennessee rates for HCPCS J9204

Injection, mogamulizumab-kpkc, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.50 / $323.05 / $541.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $248.50 / $300.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.31 / $260.22 / $297.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$243.32 / $248.50 / $248.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $248.50 / $248.50
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$324.07 / $330.55 / $1,242.50
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,074.29 / $1,074.29 / $1,074.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.34 / $248.34 / $248.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$241.05 / $248.50 / $276.63