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Wyoming rates for HCPCS J9281

Mitomycin pyelocalyceal instillation, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$317.42 / $317.42 / $317.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.52 / $318.52 / $350.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.05 / $374.18 / $374.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$300.50 / $300.50 / $300.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.52 / $390.65 / $450.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$313.00 / $318.52 / $318.52