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Wisconsin rates for HCPCS J9300

Gemtuzumab Ozogamicin Inj

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,771.19 / $6,840.64 / $9,778.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,871.00 / $3,043.26 / $3,646.17
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,712.95 / $13,712.95 / $13,712.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,866.90 / $7,866.90 / $7,866.90
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $65.00 / $70.00
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,712.95 / $13,712.95 / $13,712.95
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,866.90 / $7,866.90 / $7,866.90