go back

Hawaii rates for HCPCS J9309

Injection, polatuzumab vedotin-piiq, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $134.90 / $173.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $138.04 / $158.49
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $131.83 / $131.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $165.96 / $204.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $138.04 / $158.49