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Hawaii rates for HCPCS J9266

Injection, pegaspargase, per single dose vial

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,154.00 / $47,154.00 / $47,154.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28,424.06 / $28,424.06 / $31,266.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,154.02 / $47,154.02 / $47,154.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27,231.45 / $28,424.06 / $32,484.64
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33,702.81 / $33,702.81 / $33,702.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28,424.06 / $34,108.87 / $39,793.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27,611.94 / $28,424.06 / $42,636.09
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,272.22 / $17,927.59 / $32,755.34