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Pennsylvania rates for HCPCS J7313

Injection Fluocinolone Acetonide Intravitreal Implant (Iluvien) 0.01 Mg (Desc Rvsd 10/1/19)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$502.77 / $1,164.84 / $1,513.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.14 / $503.12 / $1,284.32
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$459.37 / $540.42 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$516.92 / $516.92 / $516.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$469.94 / $498.14 / $498.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.14 / $498.14 / $498.14
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$502.77 / $862.98 / $1,513.31
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.14 / $518.26 / $1,513.31
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$469.94 / $498.14 / $498.14
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.14 / $498.14 / $498.14
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$490.95 / $490.95 / $569.67
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$490.95 / $490.95 / $569.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.14 / $498.14 / $687.93