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Dexamethasone Lacrimal Ophthalmic Insert

Illinois rates for HCPCS J1096

Dexamethasone, lacrimal ophthalmic insert, 0.1 mg

Rates data updated July 2026.

How much does Dexamethasone Lacrimal Ophthalmic Insert cost?

$374per dose

One 0.4 mg dose, at the doctor's office rate. In Illinois, July 2026.

Negotiated ratewhat insurers pay per 0.1 mg of the drug
$93.33 / 0.1 mg
Average doseacross Medicare claims, discarded units included
× 0.4 mg
One dosedrug only; giving it and the visit are billed separately
$374

Work out the cost of a dose

This drug is priced per 0.1 mg. Enter the amount given to see what insurers have agreed to pay for it. Prefilled with the average administration in Medicare claims, discarded units included.

mg
In a doctor's office or clinic
$373
At a hospital outpatient department
$634

The same drug, in the same amount, costs 70% more at a hospital than at a doctor's office.

Drug cost only. Giving the drug, the visit itself and any monitoring are billed on their own codes. We do not publish dosing guidance: use the amount from your own prescription or treatment plan.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where the price changes

Given atPer 0.1 mgPer 0.4 mg dose
Doctor's office or clinic$93.33$374
Hospital outpatient department$158$636

How much rates vary

Facilitymedian $158 · 10th to 90th $93 to $251Professionalmedian $93 · 10th to 90th $93 to $162
$100.0$200.0$500.0$1.0K$2.0Kfacility $158professional $93

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$158.49
Typical High
$251.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$162.18
BCBS
Setting
Facility
Modifier
Global
Typical Low
$346.74
Median
$537.03
Typical High
$2,570.40
Cigna
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$173.78
Typical High
$223.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$93.33
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$199.53
Typical High
$346.74
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
Molina
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$107.15
United
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$151.36
United
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$104.71

Where Illinois sits

The same service costs 1.9 times more in Wyoming than in Maryland. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Illinois $97.72 · 26th of 51
WY $174MD $93.33

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.