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Vermont rates for HCPCS J9208

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.20 / $25.20 / $40.36
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.53 / $28.53 / $28.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.78 / $27.87 / $46.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.20 / $25.20 / $46.45
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.78 / $27.87 / $46.45
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.20 / $25.20 / $46.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.20 / $26.71 / $58.22