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North Dakota rates for HCPCS J9309

Injection, polatuzumab vedotin-piiq, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.66 / $136.66 / $245.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $136.66 / $187.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$148.27 / $149.01 / $150.91
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.47 / $149.01 / $150.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.22 / $136.66 / $171.74
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$132.86 / $149.80 / $246.01
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.22 / $151.65 / $586.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $136.66 / $162.63