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Maryland 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 / $1,185.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,007.42 / $1,185.20 / $1,517.06
CareFirst
Facility/Professional
Professional
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 / $1,333.35
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,056.00 / $1,056.00 / $1,827.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,185.20 / $1,185.20 / $1,214.95
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,046.93 / $1,046.93 / $1,046.93