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Eteplirsen Injection

Kentucky rates for HCPCS J1428 · Exondys 51

Injection, eteplirsen, 10 mg

Rates data updated July 2026.

How much does Exondys 51 (eteplirsen) cost?

$191per 10 mg

Typical negotiated rate. In Kentucky, July 2026.

Insurers have agreed to pay about $191 for each 10 mg of this drug. The price depends on where it is billed: about $158 from a physician practice, and about $191 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

Work out the cost of a dose

This drug is priced per 10 mg. Enter the amount given to see what insurers have agreed to pay for it.

mg
In a doctor's office or clinic
$158
At a hospital outpatient department
$191

The same drug, in the same amount, costs 20% 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 We do not publish dosing guidance: use the amount from your own prescription or treatment plan.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 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$158$155 to $158
FacilityA hospital or hospital-owned outpatient department$191$191 to $191

How much rates vary

Facilitymedian $191 · 10th to 90th $182 to $302Professionalmedian $158 · 10th to 90th $155 to $158
$200.0$1.0K$5.0K$20.0Kfacility $191professional $158

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
$154.88
Median
$154.88
Typical High
$323.59
Aetna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$158.49
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$190.55
Typical High
$275.42
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$158.49
CareSource
Setting
Facility
Modifier
Global
Typical Low
$41,686.94
Median
$52,480.75
Typical High
$63,095.73
CareSource
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$562.34
Cigna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$870.96
Typical High
$870.96
United
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$165.96
Typical High
$165.96
United
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$158.49

Where Kentucky sits

The same service costs 1.7 times more in Colorado than in Nebraska. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Kentucky $191 · 5th of 51
CO $263NE $155

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.