go back

Arkansas 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
$2,925.47 / $3,129.79 / $3,205.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,608.16 / $2,738.56 / $3,129.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,759.89 / $2,759.89 / $2,759.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,759.89 / $2,759.89 / $2,774.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,078.48 / $2,608.16 / $2,608.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,608.16 / $2,608.16 / $2,829.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,608.16 / $2,608.16 / $3,338.44