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Missouri 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
$2.27 / $3.20 / $4.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.29 / $3.36
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.22 / $3.77 / $7.97
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.22 / $2.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.10 / $2.10 / $2.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.22 / $2.22
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.25 / $2.84 / $85.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.92 / $2.25 / $2.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.89 / $2.22 / $2.57