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Pennsylvania rates for HCPCS J3399

Injection, onasemnogene abeparvovec-xioi, per treatment, up to 5x10^15 vector genomes

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,761,125.00 / $1,761,125.00 / $1,761,125.00
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,393,226.62 / $1,393,226.62 / $1,393,226.62
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,761,125.00 / $1,761,125.00 / $1,761,125.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,455,110.60 / $2,455,110.60 / $2,455,110.60