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.
Original text from hospital filings
MOGAMULIZUMAB-KPKC 4 MG/ML INTRAVENOUS SOLUTION
Goldsboro, NC
See all hospitals reporting HCPCS J9204 →Price type
Wayne Memorial Hospital’s median price of $3.7k is 996% above the median hospital's median price ($338), higher than 86% of the 1,430 hospitals reporting HCPCS J9204. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 21 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 · fee schedule · outpatient | $241 | $241 | — | — | — | $241 – $241 |
| 2 | Optum vaccn facility · fee schedule · outpatient | $249 | $249 | — | — | — | $249 – $249 |
| 3 | Humana medicare hmo facility · fee schedule · outpatient | $253 | $253 | — | — | — | $253 – $253 |
| 4 | Humana medicare ppo facility · fee schedule · outpatient | $253 | $253 | — | — | — | $253 – $253 |
| 5 | Cigna medicare advantage facility · fee schedule · outpatient | $261 | $261 | — | — | — | $261 – $261 |
| 6 | UnitedHealthcare medicare advantage facility · fee schedule · outpatient | $261 | $261 | — | — | — | $261 – $261 |
| 7 | Aetna medicare advantage facility · fee schedule · outpatient | $263 | $263 | — | — | — | $263 – $263 |
| 8 | Cigna commercial facility · fee schedule · outpatient | $559 | $559 | — | — | — | $559 – $559 |
| 9 | UnitedHealthcare commercial facility · fee schedule · outpatient | $677 | $677 | — | — | — | $677 – $677 |
| 10 | UnitedHealthcare individual exchange facility · fee schedule · outpatient | $677 | $677 | — | — | — | $677 – $677 |
| 11 | Amerihealth Caritas managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $3.7k | $3.7k | — | — | — | $3.7k – $3.7k |
| 12 | UnitedHealthcare chip/medicaid facility · percent of total billed charges · outpatientfrom % of charges | $3.7k | $3.7k | — | — | — | $3.7k – $3.7k |
| 13 | WellCare managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $3.7k | $3.7k | — | — | — | $3.7k – $3.7k |
| 14 | Aetna north carolina preferred facility · percent of total billed charges · outpatientfrom % of charges | $10.7k | $10.7k | — | — | — | $10.7k – $10.7k |
| 15 | Cigna commercial facility · percent of total billed charges · inpatientfrom % of charges | $11.1k | $11.1k | — | — | — | $11.1k – $11.1k |
| 16 | UnitedHealthcare individual exchange facility · percent of total billed charges · inpatientfrom % of charges | $11.1k | $11.1k | — | — | — | $11.1k – $11.1k |
| 17 | UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges | $11.7k | $11.7k | — | — | — | $11.7k – $11.7k |
| 18 | Medcost commercial/ultra facility · percent of total billed charges · outpatientfrom % of charges | $12.2k | $12.2k | — | — | — | $12.2k – $12.2k |
| 19 | Medcost commercial/ultra facility · percent of total billed charges · inpatientfrom % of charges | $12.3k | $12.3k | — | — | — | $12.3k – $12.3k |
| 20 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $13.0k | $13.0k | — | — | — | $13.0k – $13.0k |
| 21 | Blue Cross Blue Shield blue select/blue value/hmo/ppo facility · fee schedule · outpatient | $39.9k | $39.9k | — | — | — | $39.9k – $39.9k |
Last updated: Jun 18, 2026
See Mogamulizumab injection, per 1 mg pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.