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Ocriplasmin Injection

Nationwide rates for HCPCS J7316

Injection, ocriplasmin, 0.125 mg

Rates data updated July 2026.

How much does Ocriplasmin Injection cost?

$1,047per 0.125 mg

Typical negotiated rate. Nationwide, July 2026.

Insurers have agreed to pay about $1,047 for each 0.125 mg of this drug. The price depends on where it is billed: about $1,000 from a physician practice, and about $1,230 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

Work out the cost of a dose

This drug is priced per 0.125 mg. Enter the amount given to see what insurers have agreed to pay for it.

mg
In a doctor's office or clinic
$1,000
At a hospital outpatient department
$1,230

The same drug, in the same amount, costs 23% more at a hospital than at a doctor's office.

Drug cost only. Giving the drug, the visit itself and any monitoring are billed on their own codes. We do not publish dosing guidance: use the amount from your own prescription or treatment plan.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 55 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,000$977 to $1,175
FacilityA hospital or hospital-owned outpatient department$1,230$977 to $2,089

How much rates vary

Facilitymedian $1,230 · 10th to 90th $0 to $3,020Professionalmedian $1,000 · 10th to 90th $955 to $1,413
$0.1$1$10$100$1K$10Kfacility $1,230professional $1,000

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$1,584.89
Typical High
$2,951.21
Aetna
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$977.24
Typical High
$1,318.26
BCBS
Setting
Facility
Modifier
Global
Typical Low
$0.02
Median
$0.05
Typical High
$1,230.27
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,047.13
Typical High
$1,584.89
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$1,737.80
Typical High
$3,388.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,348.96
United
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$1,258.93
Typical High
$3,548.13
United
Setting
Professional
Modifier
Global
Typical Low
$1,148.15
Median
$1,174.90
Typical High
$1,380.38

What it costs in each state

The same service costs 263026.8 times more in Alabama than in Indiana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Touch or drag across the chart to see any state's rate.

AL $5,248IN $0.02

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.