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Wisconsin rates for HCPCS J9304

Injection, pemetrexed (Pemfexy), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.74 / $60.26 / $120.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $40.74 / $6,918.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $50.12 / $89.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $39.81 / $51.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $77.62 / $181.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $41.69 / $74.13
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.77 / $46.77 / $64.57
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $93.33 / $93.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.48 / $52.48 / $75.86
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $58.88 / $234.42
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $58.88 / $85.11
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $74.13 / $162.18
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $234.42
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $79.43 / $234.42
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.72 / $10.72 / $13.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $46.77 / $46.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $42.66 / $48.98