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Wisconsin 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 $977 · 10th–90th $589–$1,6980%50%10th90th$977Professionalmedian $1,000 · 10th–90th $263–$1,2300%20%40%10th90th$1,000$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$977.24 / $977.24 / $977.24
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,000.00 / $1,230.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $1,071.52 / $1,071.52
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $1,071.52 / $1,698.24
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $389.05 / $1,096.48
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $407.38 / $977.24
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $616.60
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $407.38 / $1,071.52
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,318.26
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $831.76
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $338.84 / $512.86
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $5,370.32
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,047.13
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $489.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $1,862.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,479.11