Mogamulizumab injection, per 1 mg at UPMC Hanover

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

MOGAMULIZUMAB-KPKC 4 MG/ML INTRAVENOUS SOLUTION

Hanover, PA

See all hospitals reporting HCPCS J9204 →

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Pricing by billing methodology

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How this price compares nationally

UPMC Hanover’s median price of $476 is 40% above the median hospital's median price ($339), higher than 67% of the 1,426 hospitals reporting HCPCS J9204. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J9204 at UPMC Hanover

Negotiated rates from the hospital’s own file: 9 payers, 22 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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#
1	Blue Cross Blue Shield medicare advantage facility · percent of total billed charges · outpatientfrom % of charges	$171	$171	—	—	—	$171 – $171
2	Highmark medicare facility · fee schedule · outpatient	$246	$246	—	—	—	$246 – $246
3	Amerihealth Caritas community healthchoices (chc)/medicaid facility · fee schedule · outpatient	$249	$249	—	—	—	$249 – $249
4	Humana medicare facility · fee schedule · outpatient	$249	$249	—	—	—	$249 – $249
5	Aetna medicare facility · fee schedule · outpatient	$259	$259	—	—	—	$259 – $259
6	Cigna medicare facility · fee schedule · outpatient	$261	$261	—	—	—	$261 – $261
7	UnitedHealthcare medicare facility · fee schedule · outpatient	$266	$266	—	—	—	$266 – $266
8	Cigna commercial facility · fee schedule · outpatient	$330	$330	—	—	—	$330 – $330
9	Highmark medicaid facility · fee schedule · outpatient	$539	$539	$285	53%	—	$253 – $824
10	Aetna aco facility · percent of total billed charges · inpatientfrom % of charges	$542	$542	—	—	—	$542 – $542
11	UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges	$555	$555	—	—	—	$555 – $555
12	Aetna aco facility · percent of total billed charges · outpatientfrom % of charges	$566	$566	—	—	—	$566 – $566
13	Blue Cross Blue Shield chip facility · percent of total billed charges · outpatientfrom % of charges	$612	$612	—	—	—	$612 – $612
14	Blue Cross Blue Shield commercial facility · percent of total billed charges · outpatientfrom % of charges	$612	$612	—	—	—	$612 – $612
15	Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges	$694	$694	—	—	—	$694 – $694
16	Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges	$725	$725	—	—	—	$725 – $725
17	Carefirst commercial facility · percent of total billed charges · inpatientfrom % of charges	$766	$766	—	—	—	$766 – $766
18	Carefirst commercial facility · percent of total billed charges · outpatientfrom % of charges	$766	$766	—	—	—	$766 – $766
19	MultiPlan ppo (includes phcs and humana as payers) facility · percent of total billed charges · inpatientfrom % of charges	$766	$766	—	—	—	$766 – $766
20	MultiPlan ppo (includes phcs and humana as payers) facility · percent of total billed charges · outpatientfrom % of charges	$766	$766	—	—	—	$766 – $766
21	Highmark commercial facility · fee schedule · outpatient	$884	$884	—	—	—	$884 – $884
22	UnitedHealthcare commercial facility · fee schedule · outpatient	$1.6k	$1.6k	—	—	—	$1.6k – $1.6k

Last updated: Mar 6, 2026

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