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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
$2.22 / $2.22 / $4.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.22 / $6.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.04 / $2.54 / $4.98
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.81 / $2.25 / $2.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.09 / $7.05 / $8.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.20 / $2.60 / $2.76
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.53 / $6.43 / $8.07
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.18 / $2.18 / $2.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.25 / $2.25 / $3.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.25 / $2.25 / $3.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.22 / $4.00