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Utah rates for HCPCS J9313

Injection, moxetumomab pasudotox-tdfk, 0.01 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.89 / $20.89 / $20.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $21.88 / $25.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.88 / $33.88 / $33.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.39 / $22.39 / $22.39
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.44 / $30.20 / $44.67
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.02 / $47.86 / $87.10
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.39 / $23.99 / $27.54
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.44 / $23.44 / $23.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $21.88 / $21.88