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Wisconsin rates for HCPCS J9261

Injection Nelarabine 50 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.26 / $126.76 / $145.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.86 / $82.26 / $108.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.83 / $147.74 / $178.09
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.86 / $79.86 / $107.81
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$127.78 / $143.75 / $146.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.86 / $110.27 / $201.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.25 / $80.48 / $217.91
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.38 / $82.26 / $165.27
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.73 / $159.72 / $159.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.38 / $65.28 / $139.77
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.38 / $70.56 / $4,956.64
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $65.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.38 / $82.26 / $165.27
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.73 / $159.72 / $159.72
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.86 / $97.94 / $262.32
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.86 / $79.86 / $760.75
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.86 / $152.15 / $4,956.64
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.12 / $112.12 / $240.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.86 / $83.85 / $101.03