go back

Etanercept Injection

Pennsylvania 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)

Rates data updated October 2026.

How much does Etanercept Injection cost?

$1,096

Typical negotiated rate. In Pennsylvania, October 2026.

Insurers have agreed to pay about $1,096 for this service. The price depends on where it is billed: about $1,096 from a physician practice, and about $1,230 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,096$1,096 to $1,096
FacilityA hospital or hospital-owned outpatient department$1,230$1,072 to $3,981

How much rates vary

Facilitymedian $1,230 · 10th to 90th $1,000 to $4,169Professionalmedian $1,096 · 10th to 90th $1,072 to $1,230
$500$1K$2K$5Kfacility $1,230professional $1,096

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$1,000.00
Median
$1,096.48
Typical High
$1,621.81
Aetna
Setting
Professional
Modifier
None
Typical Low
$1,096.48
Median
$1,096.48
Typical High
$1,096.48
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$549.54
Median
$549.54
Typical High
$549.54
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$218.78
Median
$218.78
Typical High
$218.78
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$109.65
Median
$109.65
Typical High
$109.65
Capital Blue Cross
Setting
Facility
Modifier
None
Typical Low
$954.99
Median
$1,071.52
Typical High
$5,011.87
Capital Blue Cross
Setting
Professional
Modifier
None
Typical Low
$1,071.52
Median
$1,071.52
Typical High
$1,071.52
Cigna
Setting
Facility
Modifier
None
Typical Low
$1,096.48
Median
$1,819.70
Typical High
$4,168.69
Cigna
Setting
Professional
Modifier
None
Typical Low
$1,096.48
Median
$1,096.48
Typical High
$1,096.48
Geisinger
Setting
Facility
Modifier
None
Typical Low
$141.25
Median
$141.25
Typical High
$141.25
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$1,000.00
Median
$1,096.48
Typical High
$1,621.81
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$1,096.48
Median
$1,096.48
Typical High
$1,096.48
Martin's Point
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$549.54
Median
$549.54
Typical High
$549.54
Martin's Point
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$218.78
Median
$218.78
Typical High
$218.78
Martin's Point
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
Martin's Point
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$109.65
Median
$109.65
Typical High
$109.65
UPMC Health Plan
Setting
Facility
Modifier
None
Typical Low
$223.87
Median
$575.44
Typical High
$1,047.13
United
Setting
Professional
Modifier
None
Typical Low
$1,071.52
Median
$1,071.52
Typical High
$1,513.56

Where Pennsylvania sits

The same service costs 8.3 times more in Arizona than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 12th of 51

$1,096

AZ $1,738MT $209

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.