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Arizona rates for HCPCS J7170

Injection, emicizumab-kxwh, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.03 / $112.20 / $168.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.71 / $63.18 / $75.81
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.94 / $187.95 / $296.30
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.60 / $50.32 / $356.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.93 / $56.10 / $56.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.10 / $56.10 / $56.10
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.14 / $75.00 / $90.35
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.43 / $57.43 / $57.43
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.06 / $56.06 / $56.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.10 / $56.10 / $56.10