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Missouri rates for HCPCS J1428

Injection, eteplirsen, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.36 / $190.55 / $630.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $158.49 / $269.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.96 / $177.83 / $588.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $144.54 / $190.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $162.18 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $162.18 / $162.18
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.88 / $190.55 / $831.76
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $158.49 / $186.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.96 / $257.04 / $257.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $158.49 / $186.21