go back

Indiana rates for HCPCS J9340

Thiotepa 15 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.05 / $438.64 / $490.10
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.91 / $82.91 / $128.51
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.91 / $82.91 / $103.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.52 / $318.17 / $335.06