go back

Wisconsin rates for HCPCS J9272

Injection Dostarlimab-Gxly 10 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.02 / $487.64 / $560.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.71 / $251.02 / $334.68
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$304.64 / $450.86 / $543.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.71 / $243.71 / $329.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.94 / $438.68 / $446.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$243.71 / $316.38 / $657.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.71 / $288.33 / $413.40
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$243.71 / $246.15 / $269.50
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$365.73 / $487.42 / $487.42
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$243.82 / $243.82 / $269.62
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.82 / $271.42 / $1,059.88
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $70.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$243.71 / $243.82 / $271.25
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$365.73 / $487.42 / $487.42
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.71 / $372.21 / $801.81
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$240.61 / $243.71 / $1,200.70
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.71 / $441.62 / $1,059.88
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$319.97 / $342.17 / $342.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.71 / $258.33 / $308.33