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Nebraska rates for HCPCS J7170

Injection, emicizumab-kxwh, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.43 / $107.83 / $124.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.10 / $56.10 / $96.38
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.98 / $63.51 / $72,824.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.32 / $62.86 / $65.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.95 / $56.10 / $66.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.65 / $57.43 / $259.89
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.98 / $57.43 / $63.17
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.98 / $78.03 / $106.37
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.70 / $65.87 / $120.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.06 / $56.10 / $56.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.30 / $56.10 / $61.71