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New York rates for HCPCS Q0139

Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (for ESRD on dialysis)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.32 / $0.32 / $2,449.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.32 / $0.36
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.32 / $1.27
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.31 / $0.99 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.32 / $0.38
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.35 / $0.51 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.35 / $0.42
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.34 / $0.34 / $0.34
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.34 / $0.34
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.31 / $0.99 / $85.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.32 / $0.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.32 / $0.46
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.34 / $0.34 / $0.34
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.34 / $0.34