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Minnesota 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 / $2.00 / $4.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.19 / $3.31 / $3.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.78 / $2.24 / $2.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.98 / $7.41 / $8.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.29 / $2.69 / $2.88
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.89 / $7.08 / $8.32
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.29 / $2.29 / $3.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.24 / $2.24 / $3.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $2.24 / $3.02
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.24 / $2.24 / $2.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $2.24 / $4.07