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Texas rates for HCPCS J7177

Injection, human fibrinogen concentrate (Fibryga), 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $2.14 / $2.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.45
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.10 / $2.63 / $5.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.15 / $1.23 / $1.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.23 / $1.23
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $85.11 / $85.11
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.23 / $1.74 / $2.95
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.23
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.12 / $1.20
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.23 / $1.78 / $3.98
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.23 / $1.32
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