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Virginia rates for HCPCS J9204

Injection, mogamulizumab-kpkc, 1 mg

Facilitymedian $309 · 10th–90th $251–$6920%20%10th90th$309Professionalmedian $251 · 10th–90th $251–$3160%50%90th$251$100.0$200.0$500.0$1.0K$2.0K$5.0K

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 / $537.03 / $707.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $288.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $501.19 / $870.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $426.58
CareFirst
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
$269.15 / $478.63 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $251.19 / $295.12
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $269.15 / $416.87
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $275.42 / $371.54
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $275.42 / $371.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $251.19 / $524.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $269.15 / $281.84