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Alabama rates for HCPCS J9268

Pentostatin Per 10 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,543.89 / $2,543.89 / $2,608.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,608.16 / $2,608.16 / $3,129.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,921.89 / $2,332.31 / $3,137.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,608.16 / $2,608.16 / $2,608.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,608.16 / $2,608.16 / $2,608.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,608.16 / $2,608.16 / $3,321.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,673.43 / $2,673.43 / $3,261.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,216.94 / $2,608.16 / $2,842.89