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Oklahoma rates for HCPCS J1428

Injection, eteplirsen, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$155.52 / $155.52 / $309.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.52 / $155.52 / $155.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$163.19 / $163.19 / $163.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.19 / $163.19 / $163.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.12 / $163.30 / $837.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.00 / $160.00 / $160.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.00 / $160.00 / $171.46