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Missouri rates for HCPCS J9266

Injection, pegaspargase, per single dose vial

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28,183.83 / $33,113.11 / $104,712.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28,183.83 / $28,840.32 / $39,810.72
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28,183.83 / $29,512.09 / $79,432.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28,183.83 / $28,183.83 / $35,481.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31,622.78 / $31,622.78 / $31,622.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26,915.35 / $28,183.83 / $28,183.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28,183.83 / $28,183.83 / $32,359.37
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26,302.68 / $31,622.78 / $47,863.01
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25,703.96 / $30,199.52 / $120,226.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28,183.83 / $33,113.11 / $36,307.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25,703.96 / $28,183.83 / $32,359.37