| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
United
| Facility | $2,455,110.60 | $2,455,110.60 | $5,278,487.79 |
Injection, onasemnogene abeparvovec-xioi, per treatment, up to 5x10^15 vector genomes
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
United
| Facility | $2,455,110.60 | $2,455,110.60 | $5,278,487.79 |