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Oklahoma rates for HCPCS J9309

Injection, polatuzumab vedotin-piiq, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$143.04 / $147.13 / $207.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $147.60 / $164.84
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.22 / $136.22 / $136.22
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.70 / $193.56 / $306.88
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
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.22 / $154.49 / $218.67
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.03 / $136.22 / $171.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $136.66 / $162.63