go back

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
$2,290.87 / $2,290.87 / $2,344.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.17 / $1.51 / $2.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.36 / $0.36 / $0.36
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.05
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.34 / $1.00 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.36 / $0.36 / $0.41
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.22 / $0.25 / $0.43
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.25 / $0.30
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.32 / $0.32 / $0.38
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
$0.40 / $0.40 / $0.40
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.41 / $0.41 / $1.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.36 / $0.36 / $0.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.36 / $0.48
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.32 / $0.34 / $0.38
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.34 / $0.34