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Ohio rates for HCPCS J9309

Injection, polatuzumab vedotin-piiq, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.66 / $296.57 / $494.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $136.66 / $181.60
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$147.60 / $234.39 / $389.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $155.80 / $230.42
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.66 / $136.66 / $205.67
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $136.66 / $184.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.93 / $135.60 / $136.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $136.66 / $171.74
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.93 / $136.66 / $206.03
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $136.66 / $193.40
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.22 / $156.66 / $192.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $136.66 / $165.37