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Mississippi 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
$2.33 / $2.67 / $2.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.33 / $3.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.14 / $2.14 / $2.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.22 / $2.22 / $2.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.22 / $2.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.13 / $2.22 / $3.04