| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $30.20 | $30.20 | $30.20 | |
United
| Facility | $2,398,832.92 | $2,570,395.78 | $5,623,413.25 | |
United
| Professional | $1,659,586.91 | $2,398,832.92 | $3,162,277.66 |
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 | $30.20 | $30.20 | $30.20 | |
United
| Facility | $2,398,832.92 | $2,570,395.78 | $5,623,413.25 | |
United
| Professional | $1,659,586.91 | $2,398,832.92 | $3,162,277.66 |