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Utah rates for HCPCS J9281

Mitomycin Pyelocalyceal Instillation 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$369.50 / $369.50 / $369.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.52 / $318.52 / $369.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$364.23 / $439.77 / $472.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.52 / $318.52 / $318.52
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $365.03 / $422.55
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$462.23 / $619.45 / $889.31
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$350.38 / $431.74 / $454.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.52 / $318.52 / $318.52