go back

Nebraska 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 / $62,828.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28,424.06 / $28,424.06 / $47,701.30
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26,211.67 / $30,837.26 / $30,837.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33,116.30 / $34,859.26 / $34,859.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27,736.39 / $36,200.44 / $41,688.62
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,166.87 / $36,382.80 / $55,426.92
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27,070.53 / $30,129.50 / $42,636.09
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,391.65 / $40,605.80 / $50,273.85
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,216.85 / $33,435.00 / $42,636.09
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,544.40 / $33,256.15 / $57,985.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28,424.06 / $28,424.06 / $33,824.62