go back

North Carolina 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
$2.06 / $2.62 / $4.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.06 / $2.22 / $2.74
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.49 / $5.93 / $7.11
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.25 / $2.25 / $2.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.10 / $2.22 / $2.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.22 / $3.20
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.06 / $2.64 / $3.52
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.04 / $2.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.22 / $2.89
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $75.00 / $85.00