Mogamulizumab injection, per 1 mg

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

PR MOGAMULIZUMAB-KPKC 1 MG INJ

Payers reporting HCPCS J9204

Payer pricing summary

Low

$133

Average

$3.9k

Median

$2.1k

High

$19.4k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +25 other terms	584	$377	$695	$4.2k	607%	—	$1 – $114.2k
2	Aetna fee schedule · outpatient · +23 other terms	394	$282	$1.7k	$9.9k	587%	—	$1 – $122.5k
3	Cigna fee schedule · outpatient · +19 other terms	353	$365	$1.3k	$6.4k	485%	—	$71 – $89.1k
4	Blue Cross Blue Shield fee schedule · outpatient · +24 other terms	335	$372	$607	$753	124%	—	$1 – $6.2k
5	Humana fee schedule · outpatient · +20 other terms	319	$246	$478	$1.7k	355%	—	$1 – $26.8k
6	Molina fee schedule · outpatient · +21 other terms	134	$369	$1.5k	$5.0k	334%	—	$1 – $48.1k
7	Anthem fee schedule · outpatient · +20 other terms	124	$336	$578	$1.3k	229%	—	$210 – $14.7k
8	WellCare fee schedule · outpatient · +12 other terms	122	$252	$312	$205	66%	—	$228 – $1.3k
9	Caresource fee schedule · outpatient · +14 other terms	80	$284	$455	$860	189%	—	$1 – $5.7k
10	Kaiser fee schedule · outpatient · +18 other terms	74	$380	$2.3k	$9.5k	416%	—	$203 – $83.5k
11	Ambetter facility · fee schedule · outpatient · +12 other terms	68	$456	$479	$102	21%	—	$243 – $620
12	Devoted fee schedule · outpatient · +12 other terms	62	$249	$250	$12	5%	—	$226 – $270
13	Highmark facility · fee schedule · outpatient · +11 other terms	57	$297	$364	$198	54%	—	$99 – $1.1k
14	Amerihealth Caritas facility · fee schedule · outpatient · +11 other terms	37	$258	$622	$2.4k	382%	—	$248 – $16.5k
15	Optum facility · fee schedule · outpatient · +17 other terms	33	$249	$544	$1.5k	273%	—	$199 – $8.0k
16	Oscar facility · fee schedule · outpatient · +12 other terms	33	$318	$338	$67	20%	—	$253 – $460
17	Bcbs Tx fee schedule · outpatient · +2 other terms	31	$752	$697	$299	43%	—	$228 – $1.3k
18	Clover fee schedule · outpatient · +7 other terms	29	$269	$396	$345	87%	—	$235 – $1.3k
19	Medicare fee schedule · outpatient · +10 other terms	29	$244	$262	$136	52%	—	$211 – $1.3k
20	MultiPlan fee schedule · outpatient · +14 other terms	28	$394	$21.3k	$38.7k	182%	—	$249 – $125.3k
21	Baylor Scott White Health Plan facility · fee schedule · outpatient · +2 other terms	27	$290	$290	$65	23%	—	$225 – $418
22	Aetna Better Health fee schedule · outpatient · +16 other terms	23	$249	$255	$13	5%	—	$241 – $275
23	Medical Mutual facility · fee schedule · outpatient · +7 other terms	21	$464	$523	$244	47%	—	$138 – $1.1k
24	Regence facility · fee schedule · outpatient · +8 other terms	21	$264	$292	$88	30%	—	$211 – $541
25	Superior Healthplan facility · fee schedule · outpatient · +4 other terms	21	$266	$261	$6	2%	—	$253 – $266

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