go back

Idaho rates for HCPCS J9309

Injection, polatuzumab vedotin-piiq, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.22 / $136.22 / $156.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $142.19 / $170.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.93 / $128.93 / $136.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $136.66 / $136.66
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.22 / $170.83 / $218.66
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $144.87 / $170.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.08 / $119.62 / $258.82
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.46 / $175.45 / $315.25
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.34 / $164.00 / $164.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $136.66 / $144.87