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Wisconsin rates for HCPCS J7168

Prothrombin complex concentrate (human), Kcentra, per IU of Factor IX activity

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.86 / $6.38 / $18,820.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.86 / $2.86 / $3.58
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.96 / $4.59 / $4.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.98 / $2.98 / $3.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.23 / $2.25 / $3.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.04 / $3.04 / $3.04
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.86 / $3.58 / $3.58
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.14 / $3.19 / $4.75
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.98 / $2.98 / $3.87
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.09 / $65.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.86 / $3.58 / $3.58
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.04 / $3.04 / $85.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.04 / $3.04 / $3.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.18 / $2.18 / $5.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.98 / $2.98 / $4.08