go back

Maryland rates for HCPCS J9266

Injection, pegaspargase, per single dose vial

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28,424.10 / $28,424.10 / $32,867.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28,424.06 / $28,424.06 / $42,351.90
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28,424.06 / $28,424.06 / $28,424.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27,070.53 / $27,070.53 / $27,351.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28,424.06 / $28,424.06 / $33,518.94
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24,160.45 / $28,424.06 / $28,960.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28,424.06 / $31,641.95 / $33,921.26
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27,070.53 / $27,070.53 / $38,372.48