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Alaska rates for HCPCS J9331

Injection, sirolimus protein-bound particles, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.82 / $562.34 / $562.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $128.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $87.10
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.10 / $104.71 / $218.78
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $109.65 / $218.78
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.10 / $134.90 / $208.93
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $114.82 / $114.82
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.10 / $112.20 / $169.82
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $158.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $131.83 / $245.47