go back

Utah rates for HCPCS J9325

Injection, talimogene laherparepvec, per 1 million plaque forming units

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $85.11 / $85.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $74.13 / $91.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.28 / $100.00 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $74.13 / $75.86
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $74.13 / $95.50
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $123.03 / $245.47
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $81.28 / $107.15
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $75.86 / $75.86
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $74.13 / $89.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $74.13 / $74.13