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Pennsylvania rates for HCPCS J0717

Injection, certolizumab pegol, 1 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.95 / $10.51 / $13.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.91 / $5.36 / $2,678.40
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.61 / $4.25 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.05 / $4.05 / $4.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.69 / $3.91 / $3.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.91 / $3.91 / $3.91
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.53 / $10.51 / $13.65
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.91 / $5.43 / $2,418.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.69 / $3.91 / $3.91
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.91 / $3.91 / $3.91
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.05 / $5.05 / $5.87
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.05 / $5.05 / $5.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.91 / $3.91 / $6.74