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Utah rates for HCPCS J9204

Injection, mogamulizumab-kpkc, 1 mg

Facilitymedian $331 · 10th–90th $295–$6170%20%40%10th90th$331Professionalmedian $251 · 10th–90th $251–$3090%50%90th$251$50.0$100.0$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
$295.12 / $295.12 / $295.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $257.04 / $316.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $346.74 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $251.19 / $331.13
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $501.19 / $724.44
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $371.54
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $263.03 / $263.03
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $251.19 / $302.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $251.19 / $251.19