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Washington rates for HCPCS J7177

Injection, human fibrinogen concentrate (Fibryga), 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.23 / $2.14 / $2.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.15 / $1.15 / $2.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.23 / $1.51
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.10 / $1.23 / $1.86
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.93 / $1.29 / $3.09
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.20 / $1.29 / $1.38
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.10 / $1.32 / $3.16
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.23 / $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
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.23 / $1.58