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Arkansas rates for HCPCS J7204

Injection Factor Viii Antihemophilic Factor (Recombinant) (Esperoct) Glycopegylated-Exei Per Iu

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.60 / $2.67 / $3.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.67 / $2.71
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.45 / $2.45 / $2.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.45 / $2.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.10 / $2.22 / $2.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.22 / $2.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.22 / $2.72