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Pennsylvania rates for HCPCS J7177

Injection, human fibrinogen concentrate (Fibryga), 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.23 / $3.02 / $3.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.32
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.12 / $1.32 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.26 / $1.26 / $1.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.23 / $1.23 / $1.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.23 / $1.23
Geisinger
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.23 / $1.23 / $1.23
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.86 / $2.14 / $2.14
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.23 / $2.88 / $3.72
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $3.39
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $1.74 / $1.95
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.74 / $1.95
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 / $1.70