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Washington rates for HCPCS J9204

Injection, mogamulizumab-kpkc, 1 mg

Facilitymedian $288 · 10th–90th $224$6030%20%10th90th$288Professionalmedian $257 · 10th–90th $251$3800%50%10th90th$257$50.0$200.0$1.0K$5.0K$20.0K

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
$263.03 / $436.52 / $602.56
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $257.04 / $323.59
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $302.00 / $741.31
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $281.84 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $380.19 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $295.12
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $263.03 / $602.56
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $263.03 / $524.81
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $251.19 / $302.00
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $281.84 / $512.86
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $275.42 / $776.25
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $288.40
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $295.12 / $741.31
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $281.84 / $281.84
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
$229.09 / $251.19 / $281.84
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $251.19 / $331.13