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Massachusetts rates for HCPCS J1438

Injection, etanercept, 25 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)

Facilitymedian $1,349 · 10th–90th $1,047–$2,3990%20%10th90th$1,349Professionalmedian $955 · 10th–90th $407–$1,0720%20%10th90th$955$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,621.81 / $2,137.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,023.29 / $1,148.15
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $891.25 / $2,290.87
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $1,047.13 / $1,318.26
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $2,398.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,290.87 / $4,786.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $1,096.48 / $1,096.48
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $5,888.44 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $870.96
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $891.25 / $2,290.87
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $1,047.13 / $1,318.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $1,318.26 / $1,698.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $1,047.13 / $1,122.02