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Montana rates for HCPCS J7204

Injection, Factor VIII, antihemophilic factor (recombinant), (Esperoct), glycopegylated-exei, per IU

Facilitymedian $2 · 10th–90th $2$40%50%10th90th$2Professionalmedian $2 · 10th–90th $2$60%50%10th90th$2$2.0$5.0$10.0$20.0$50.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.00
Median
$2.00
Typical High
$5.75
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2.45
Median
$2.45
Typical High
$2.45
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2.24
Median
$2.24
Typical High
$2.45
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$2.24
Median
$2.29
Typical High
$6.31
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$2.24
Median
$2.29
Typical High
$6.31
Providence
Setting
Facility
Modifier
Global
Typical Low
$2.45
Median
$2.45
Typical High
$2.45
Providence
Setting
Professional
Modifier
Global
Typical Low
$2.24
Median
$3.16
Typical High
$85.11
United
Setting
Professional
Modifier
Global
Typical Low
$2.24
Median
$2.24
Typical High
$2.24