go back

Wyoming rates for HCPCS J9309

Injection, polatuzumab vedotin-piiq, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.22 / $136.22 / $136.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $138.03 / $158.53
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.60 / $159.53 / $159.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.93 / $128.93 / $128.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $167.61 / $193.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.66 / $136.66 / $136.66