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Virginia 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 $1,148 · 10th–90th $794–$2,4550%20%10th90th$1,148Professionalmedian $1,047 · 10th–90th $977–$1,0720%50%10th90th$1,047$10.0$50.0$200.0$1.0K

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 / $2,089.30 / $2,754.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,047.13 / $1,047.13
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $870.96 / $1,412.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,737.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $2,137.96 / $2,754.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,096.48
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $204.17 / $1,288.25
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $204.17
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $1,047.13 / $1,584.89
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,148.15 / $1,584.89
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,148.15 / $1,584.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $954.99 / $2,089.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,071.52 / $1,230.27