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Minnesota rates for HCPCS J9208

Ifosfamide 1 Gm (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.20 / $25.20 / $25.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.20 / $25.20 / $28.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $29.03 / $60.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.74 / $38.76 / $81.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.20 / $27.60 / $31.86
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.44 / $38.92 / $88.71
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.09 / $25.09 / $27.08
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.50 / $23.50 / $74.53
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.50 / $26.16 / $228.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.20 / $26.71 / $49.68