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Utah rates for HCPCS J9309

Injection, polatuzumab vedotin-piiq, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.53 / $19,851.59 / $34,119.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $138.03 / $170.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$155.47 / $181.74 / $201.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $136.66 / $136.66
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $136.66 / $179.18
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$210.54 / $270.32 / $376.88
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.34 / $185.24 / $194.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $136.66 / $136.66