go back

Hawaii rates for HCPCS J7201

Injection, Factor IX, Fc fusion protein, (recombinant), Alprolix, 1 IU

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.72 / $6.72 / $6.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.72 / $6.72 / $6.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.59 / $3.59 / $3.59
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.95 / $4.30 / $5.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.59 / $4.29 / $5.39
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.37 / $4.20 / $4.62