go back

Texas rates for HCPCS J7170

Injection, emicizumab-kxwh, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.10 / $93.12 / $119.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.10 / $56.66 / $78.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.71 / $54.71 / $54.71
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
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $274.89 / $280.50
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.66 / $80.22 / $82.63
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.07 / $56.10 / $101.43
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.93 / $56.10 / $81.02
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.88 / $56.10 / $94.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.06 / $56.06 / $56.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.10 / $56.10 / $56.10
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.02 / $52.02 / $75.73