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New York rates for HCPCS J1428

Injection, eteplirsen, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.60 / $153.60 / $230.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.47 / $153.60 / $163.19
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.88 / $133.88 / $167.35
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.00 / $160.00 / $160.00
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$160.00 / $160.00 / $176.00
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.00 / $160.00 / $160.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$163.19 / $173.14 / $173.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.19 / $163.19 / $163.19
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$163.19 / $163.19 / $264.38
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.19 / $163.19 / $187.68
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$159.99 / $169.60 / $169.60
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.99 / $169.60 / $169.60
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$163.19 / $173.14 / $597.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.19 / $163.19 / $243.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.00 / $160.00 / $240.00
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$159.99 / $159.99 / $159.99
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.99 / $159.99 / $169.60