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Michigan rates for HCPCS J9281

Mitomycin pyelocalyceal instillation, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$326.94 / $425.02 / $634.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.52 / $321.72 / $350.38
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$370.04 / $694.74 / $1,323.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$308.31 / $337.52 / $438.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.52 / $318.52 / $405.00
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$318.52 / $634.84 / $909.71
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.52 / $321.72 / $384.72
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$313.00 / $349.16 / $476.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.52 / $337.64 / $383.52