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Nebraska 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
$2.24 / $4.07 / $5.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.24 / $5.75
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.91 / $2.40 / $2.51
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.40 / $2.45 / $2.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $2.29 / $2.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.09 / $2.24 / $85.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.14 / $2.24 / $2.51
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.57 / $3.31 / $3.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.95 / $2.24 / $4.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.14 / $2.24 / $3.39