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Wyoming rates for HCPCS J9204

Injection, mogamulizumab-kpkc, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.50 / $248.50 / $248.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $248.50 / $273.35
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.90 / $286.94 / $286.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.43 / $234.43 / $234.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $304.76 / $351.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.50 / $248.50 / $248.50