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Idaho rates for HCPCS J9281

Mitomycin pyelocalyceal instillation, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$317.42 / $317.42 / $365.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$317.42 / $328.09 / $398.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$300.50 / $300.50 / $318.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.52 / $318.52 / $318.52
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$317.42 / $398.16 / $509.64
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.52 / $337.64 / $398.16
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$230.07 / $280.22 / $610.35
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$321.99 / $459.06 / $770.04
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$382.24 / $382.24 / $398.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.52 / $318.52 / $337.64