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Utah rates for HCPCS J9205

Injection, irinotecan liposome, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.56 / $76.56 / $76.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.00 / $66.65 / $82.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.12 / $90.69 / $97.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.00 / $66.00 / $66.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $66.00 / $88.10
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.68 / $131.83 / $183.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.59 / $89.46 / $94.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.00 / $66.00 / $66.00