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New Mexico rates for HCPCS J9309

Injection, polatuzumab vedotin-piiq, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$147.91 / $213.80 / $478.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $138.04 / $190.55
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $707.95 / $1,202.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $117.49 / $199.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $165.96 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $138.04 / $138.04
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $151.36 / $288.40
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $141.25 / $229.09
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $138.04 / $165.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $138.04 / $138.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $138.04 / $144.54