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West Virginia rates for HCPCS J1428

Injection, eteplirsen, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$163.19 / $163.19 / $192.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.36 / $163.19 / $163.19
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$233.01 / $44,999.55 / $69,999.30
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 / $243.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.00 / $160.00 / $192.00