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Ocriplasmin Injection

Kentucky rates for HCPCS J7316

Injection, ocriplasmin, 0.125 mg

Rates data updated July 2026.

How much does Ocriplasmin Injection cost?

$1,230per 0.125 mg

Typical negotiated rate. In Kentucky, July 2026.

Insurers have agreed to pay about $1,230 for each 0.125 mg of this drug. The price depends on where it is billed: about $1,047 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
$1,047
At a hospital outpatient department
$1,230

The same drug, in the same amount, costs 17% 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 We do not publish dosing guidance: use the amount from your own prescription or treatment plan.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$1,047$977 to $1,047
FacilityA hospital or hospital-owned outpatient department$1,230$1,230 to $1,230

How much rates vary

Facilitymedian $1,230 · 10th to 90th $955 to $1,230Professionalmedian $1,047 · 10th to 90th $977 to $1,175
$0.1$1$10$100$1Kfacility $1,230professional $1,047

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
$954.99
Median
$1,995.26
Typical High
$1,995.26
Aetna
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$977.24
Typical High
$977.24
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$0.03
Median
$1,230.27
Typical High
$1,230.27
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,047.13
CareSource
Setting
Facility
Modifier
Global
Typical Low
$41,686.94
Median
$52,480.75
Typical High
$63,095.73
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$1,000.00
Typical High
$3,630.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,047.13
United
Setting
Professional
Modifier
Global
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$1,174.90

Where Kentucky 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.

Kentucky· 9th of 51

$1,230

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.