HCPCS Level II J9306: Injection, pertuzumab, 1 mg
Commercial payers pay $79 on average nationally for this procedure.
HCPCS Level II code J9306 represents the drug supply for pertuzumab, billed per 1 mg of the injected monoclonal antibody; the service is a parenteral oncology infusion typically administered in an outpatient infusion center or hospital outpatient department for treatment of HER2-positive breast cancer.
For related coverage guidance, see recent payer policy updates: Epithelial Cell Cytology in Breast Cancer Risk Assessment, Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only), Umbilical Cord Blood Harvesting and Storage for Future Use (for Indiana Only).
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National Reimbursement Benchmarks
Commercial commercial average (BUCA) for HCPCS J9306 centers near $78.70, while individual national commercial payers display varied central tendencies: Aetna’s median is $17.00, Blue Cross Blue Shield’s median is $15.80, Cigna’s median is $17.00, and UnitedHealth Group’s median is $18.00. These medians cluster in the mid-teens, but BUCA’s mean at $78.70 indicates that broader commercial contracting can sit considerably higher than the typical payer median, reflecting heavier weight from higher outliers in pooled commercial arrangements.
Dispersion measured as P75 minus P25 highlights relative tightness: Blue Cross Blue Shield’s dispersion is $1.50 (P75 $16.80 minus P25 $15.30) and UnitedHealth Group’s dispersion is $2.50 (P75 $19.50 minus P25 $17.00), which are the tightest spreads. Aetna’s dispersion is unusually wide at $12.30 (P75 $17.00 minus P25 $4.70), indicating substantial heterogeneity in allowed amounts. Cigna’s dispersion is $2.30 (P75 $19.30 minus P25 $17.00), and BUCA’s interquartile band (P75 $17.50 minus P25 $14.30) is $3.20, placing it between the tightest payers and Aetna’s wide variation.