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Pennsylvania rates for HCPCS J1428

Injection, eteplirsen, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$163.19 / $261.12 / $404.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.19 / $163.19 / $163.19
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$135.46 / $159.36 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.36 / $159.36 / $159.36
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
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$182.40 / $182.40 / $182.40
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$163.19 / $251.33 / $404.74
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.19 / $163.19 / $324.77
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$163.19 / $163.19 / $163.19
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.19 / $163.19 / $163.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.00 / $160.00 / $275.76