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Arkansas rates for HCPCS J9309

Injection, polatuzumab vedotin-piiq, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$156.66 / $164.00 / $171.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $143.50 / $164.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.22 / $136.22 / $136.22
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$147.80 / $147.80 / $147.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.72 / $147.80 / $147.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.85 / $132.91 / $136.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $136.66 / $148.27
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$156.66 / $156.66 / $156.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.12 / $136.66 / $157.16