go back

Utah rates for HCPCS J9331

Injection Sirolimus Protein-Bound Particles 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$98.10 / $98.10 / $98.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.57 / $84.57 / $98.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.05 / $155.12 / $178.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.57 / $84.57 / $84.57
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $60.00 / $97.25
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$166.06 / $229.75 / $329.85
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.03 / $114.63 / $120.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.57 / $84.57 / $84.57