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Oklahoma rates for HCPCS J7177

Injection, human fibrinogen concentrate (Fibryga), 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.21 / $1.30 / $2.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.32 / $1.32 / $1.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.15 / $1.15 / $1.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.23 / $1.23
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.21 / $1.30 / $75.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.10 / $1.21 / $1.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.23 / $1.23 / $1.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.23 / $1.23