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Michigan rates for HCPCS J1428

Injection, eteplirsen, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.60 / $153.60 / $479.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.60 / $153.60 / $153.60
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$163.19 / $163.19 / $163.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.04 / $163.19 / $163.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.19 / $163.19 / $163.19
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.60 / $192.00 / $427.39
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.60 / $169.60 / $203.52
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.00 / $160.00 / $169.76