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Louisiana rates for HCPCS J7316

Injection Ocriplasmin 0.125 Mg (Code Was Deleted01/01/03 But Reinstated On 01/01/14) Sodium Hyaluronate 5 Mg For Intra-Articular Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,185.20 / $1,185.20 / $1,659.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,185.20 / $1,185.20 / $1,185.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$823.27 / $1,066.68 / $1,312.07
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,066.68 / $1,066.68 / $1,088.01
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,046.93 / $1,046.93 / $1,046.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,046.93 / $1,046.93 / $1,046.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,185.20 / $1,185.20 / $1,306.68