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Massachusetts 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
$2.00 / $3.47 / $6.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.00 / $4.27
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.09 / $5.62 / $7.41
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $2.24 / $2.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.24 / $2.24 / $4.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.24 / $2.24 / $2.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $2.24 / $2.24
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.24 / $56.23 / $8,511.38
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $2.24 / $4.07
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.09 / $5.62 / $7.41
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $2.24 / $2.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.14 / $2.24 / $4.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $2.24 / $3.16