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Mississippi 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
$2,738.56 / $3,052.67 / $3,129.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,608.16 / $2,634.24 / $3,129.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,940.21 / $1,940.21 / $2,134.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,582.56 / $1,582.56 / $2,054.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,608.16 / $2,608.16 / $2,732.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,608.16 / $2,608.16 / $2,647.57
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,335.71 / $2,673.43 / $3,555.66
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,833.84 / $2,833.84 / $2,833.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,477.75 / $2,608.16 / $3,442.77