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Michigan rates for HCPCS J9266

Injection, pegaspargase, per single dose vial

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29,512.09 / $54,954.09 / $91,201.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28,183.83 / $28,183.83 / $33,884.42
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28,840.32 / $60,255.96 / $125,892.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27,542.29 / $28,840.32 / $30,199.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28,183.83 / $28,183.83 / $30,902.95
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26,915.35 / $42,657.95 / $91,201.08
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28,183.83 / $28,840.32 / $37,153.52
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28,183.83 / $28,183.83 / $30,902.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26,915.35 / $28,183.83 / $28,183.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26,915.35 / $30,199.52 / $33,884.42