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Hawaii rates for HCPCS J9281

Mitomycin pyelocalyceal instillation, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$570.20 / $570.20 / $570.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.52 / $318.52 / $350.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.52 / $318.52 / $373.63
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$329.49 / $387.64 / $445.79
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.52 / $382.24 / $477.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$317.58 / $335.30 / $477.80
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.30 / $363.91 / $401.65