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Kentucky 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
$2.22 / $2.22 / $3.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.22 / $2.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.52 / $2.63 / $4.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.88 / $2.22 / $2.22
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.22 / $2.22 / $3.55
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.33 / $3.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.22 / $2.22 / $2.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $4.09 / $4.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.22 / $2.22