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Michigan 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
$2.29 / $2.33 / $7.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.29 / $2.73
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.84 / $4.94 / $9.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.15 / $2.25 / $2.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.22 / $2.22
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.22 / $3.20 / $6.48
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.29 / $2.66
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.46 / $2.55 / $2.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.22 / $2.36