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Utah rates for HCPCS J9325

Injection Talimogene Laherparepvec Per 1 Millionplaque Forming Units

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.76 / $85.76 / $85.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.94 / $74.67 / $92.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.31 / $97.37 / $106.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.94 / $73.94 / $73.94
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $73.94 / $95.01
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.14 / $141.32 / $202.88
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.33 / $100.22 / $105.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.94 / $73.94 / $73.94