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Eteplirsen Injection

Massachusetts rates for HCPCS J1428 · Exondys 51

Injection, eteplirsen, 10 mg

Rates data updated July 2026.

How much does Exondys 51 (eteplirsen) cost?

$162per 10 mg

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $162 for each 10 mg of this drug. The price depends on where it is billed: about $162 from a physician practice, and about $204 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
$162
At a hospital outpatient department
$204

The same drug, in the same amount, costs 26% 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 We do not publish dosing guidance: use the amount from your own prescription or treatment plan.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 8 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$162$162 to $162
FacilityA hospital or hospital-owned outpatient department$204$182 to $269

How much rates vary

Facilitymedian $204 · 10th to 90th $166 to $380Professionalmedian $162 · 10th to 90th $162 to $263
$100.0$1.0K$10.0Kfacility $204professional $162

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
$162.18
Median
$269.15
Typical High
$380.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$831.76
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$239.88
BCBS
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$363.08
Cigna
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$338.84
Typical High
$707.95
Cigna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$204.17
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$263.03
Typical High
$7,079.46
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$275.42
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$831.76
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$239.88
United
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$165.96
Typical High
$363.08
United
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$162.18
Typical High
$169.82

Where Massachusetts 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.

Massachusetts $162 · 18th 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.