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Indiana rates for HCPCS J7170

Injection, emicizumab-kxwh, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.66 / $126.77 / $261.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.10 / $56.66 / $57.43
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.10 / $112.20 / $148.66
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.68 / $56.10 / $79.66
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.10 / $61.71 / $84.15
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.10 / $61.71 / $61.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.10 / $56.10 / $56.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.95 / $56.10 / $145.26
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 / $70.15