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Kansas 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
$2,594.77 / $3,541.54 / $11,193.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,608.16 / $2,816.81 / $3,651.42
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,675.74 / $2,854.42 / $3,159.56
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,749.95 / $2,749.95 / $2,749.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,460.53 / $2,608.16 / $2,913.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,608.16 / $2,608.16 / $2,608.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,543.89 / $2,926.88 / $3,881.98
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,543.89 / $2,831.88 / $12,064.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,261.58 / $3,261.58 / $3,261.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,608.16 / $2,764.65 / $3,103.71