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Wisconsin rates for HCPCS J9205

Injection Irinotecan Liposome 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.98 / $130.52 / $149.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.00 / $66.66 / $90.63
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.50 / $122.10 / $147.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.00 / $66.00 / $89.10
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$105.60 / $118.80 / $120.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.00 / $98.52 / $180.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.00 / $83.16 / $121.78
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.95 / $66.00 / $72.59
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.89 / $132.00 / $132.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.95 / $65.26 / $72.16
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.26 / $72.65 / $283.51
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $65.28 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.90 / $66.00 / $72.59
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.89 / $132.00 / $132.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.00 / $84.54 / $199.00
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.00 / $66.00 / $326.39
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.00 / $118.13 / $283.51
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.06 / $92.66 / $92.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.00 / $69.30 / $83.15