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Wisconsin rates for HCPCS J9211

Idarubicin Hydrochloride 5 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.77 / $74.09 / $417.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.67 / $37.77 / $44.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.84 / $45.84 / $45.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.67 / $36.67 / $49.50
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.67 / $66.01 / $67.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.67 / $62.51 / $129.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.67 / $55.41 / $84.29
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.67 / $37.04 / $75.89
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.58 / $73.34 / $203.89
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.04 / $37.04 / $75.89
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.04 / $41.24 / $1,379.87
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $70.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.67 / $37.04 / $80.56
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.58 / $73.34 / $203.89
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.67 / $57.07 / $145.00
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.67 / $36.67 / $875.51
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.67 / $86.09 / $1,379.87
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.00 / $51.48 / $60.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.67 / $38.50 / $46.39