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Ocriplasmin Injection

Illinois rates for HCPCS J7316

Injection, ocriplasmin, 0.125 mg

Rates data updated July 2026.

How much does Ocriplasmin Injection cost?

$2,089per 0.125 mg

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $2,089 for each 0.125 mg of this drug. The price depends on where it is billed: about $1,259 from a physician practice, and about $2,089 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
$1,259
At a hospital outpatient department
$2,089

The same drug, in the same amount, costs 66% 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 We do not publish dosing guidance: use the amount from your own prescription or treatment plan.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 5 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$1,259$1,047 to $2,089
FacilityA hospital or hospital-owned outpatient department$2,089$1,995 to $2,188

How much rates vary

Facilitymedian $2,089 · 10th to 90th $1,549 to $3,890Professionalmedian $1,259 · 10th to 90th $977 to $2,089
$100$500$2K$10Kfacility $2,089professional $1,259

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
$1,548.82
Median
$2,089.30
Typical High
$2,454.71
Aetna
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$2,089.30
Typical High
$2,089.30
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,630.27
Median
$6,025.60
Typical High
$17,782.79
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,479.11
Median
$1,949.84
Typical High
$2,511.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,047.13
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$1,479.11
Typical High
$1,819.70
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
United
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$1,174.90
United
Setting
Professional
Modifier
Global
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$1,202.26

Where Illinois sits

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.

Illinois· 3rd of 51

$2,089

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.