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Wisconsin rates for HCPCS J3399

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

Facilitymedian $2,238,721 · 10th–90th $0–$2,754,2290%50%10th90th$2,238,721Professionalmedian $2,570,396 · 10th–90th $2,570,396–$2,570,3960%50%$2,570,396$0.0$0.5$10.0$200.0$5.0K$100.0K$2.0M

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
$2,238,721.14 / $2,238,721.14 / $2,238,721.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.02
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570,395.78 / $2,570,395.78 / $2,570,395.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318,256.74 / $2,454,708.92 / $3,548,133.89
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398,832.92 / $2,454,708.92 / $2,511,886.43
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454,708.92 / $2,454,708.92 / $2,454,708.92
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137,962.09 / $2,137,962.09 / $2,137,962.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570,395.78 / $2,570,395.78 / $5,623,413.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398,832.92 / $2,398,832.92 / $2,398,832.92