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Utah rates for HCPCS J9320

Streptozocin 1 Gm (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,294.80 / $1,294.80 / $1,294.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$915.80 / $1,294.80 / $1,341.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,326.00 / $1,326.00 / $1,326.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $411.42 / $473.83
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$565.92 / $747.76 / $1,073.52
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.22 / $438.93 / $462.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,300.00 / $1,300.00 / $1,300.00