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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)

Facilitymedian $1,738 · 10th–90th $1,023–$2,8840%10%10th90th$1,738Professionalmedian $1,047 · 10th–90th $891–$1,0470%50%10th$1,047$200.0$1.0K$5.0K$20.0K

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 / $1,737.80 / $2,884.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,047.13 / $1,047.13
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $1,023.29 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,023.29
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $3,801.89 / $4,073.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,096.48
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,047.13 / $1,621.81
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,047.13 / $1,047.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,513.56