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South 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
$2.33 / $2.33 / $9.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.06 / $2.33 / $3.66
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.85 / $2.92 / $4.91
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.31 / $2.82 / $3.49
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 / $2.22
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.33 / $2.80 / $5.51
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.82 / $3.82 / $3.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.22 / $2.22 / $2.22