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Texas rates for HCPCS J9309

Injection, polatuzumab vedotin-piiq, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.66 / $206.39 / $277.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $137.59 / $164.84
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.22 / $164.00 / $164.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$126.22 / $319.45 / $637.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.21 / $135.54 / $135.54
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.30 / $127.62 / $15,218.47
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,812.45 / $11,812.45 / $11,812.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.93 / $136.66 / $136.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $136.66 / $136.66
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$176.56 / $663.65 / $683.35
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$586.87 / $586.87 / $586.87
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.22 / $136.66 / $281.54
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $139.40 / $225.51
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.44 / $150.44 / $255.50
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.66 / $136.66 / $243.95
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $136.66 / $162.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $144.87 / $153.07
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.91 / $136.66 / $191.34