go back

Vermont rates for HCPCS J9268

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,608.16 / $2,608.16 / $5,397.93
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,952.63 / $2,952.63 / $2,952.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,460.53 / $3,026.53 / $5,044.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,608.16 / $2,608.16 / $5,044.21
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,460.53 / $3,026.53 / $5,044.21
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,608.16 / $2,608.16 / $5,044.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,608.16 / $2,764.65 / $6,025.89