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North Dakota 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 / $4.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.22 / $2.73
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.41 / $2.42 / $2.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.42 / $2.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.18 / $2.20 / $2.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.25 / $3.20 / $6.78
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.14 / $2.25 / $2.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.89 / $2.22 / $2.49