| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2,398,832.92 | $2,398,832.92 | $2,398,832.92 | |
Providence
| Professional | $79.43 | $79.43 | $85.11 |
Injection, onasemnogene abeparvovec-xioi, per treatment, up to 5x10^15 vector genomes
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2,398,832.92 | $2,398,832.92 | $2,398,832.92 | |
Providence
| Professional | $79.43 | $79.43 | $85.11 |