go back

Vermont rates for HCPCS J9313

Injection Moxetumomab Pasudotox-Tdfk 0.01 Mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.51 / $22.51 / $58.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.64 / $52.64 / $52.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.51 / $22.51 / $52.64
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.64 / $52.64 / $52.64
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.51 / $22.51 / $52.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.07 / $23.39 / $50.99