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Ocriplasmin Injection

North Carolina rates for HCPCS J7316

Injection, ocriplasmin, 0.125 mg

Rates data updated July 2026.

How much does Ocriplasmin Injection cost?

$1,000per 0.125 mg

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $1,000 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 $1,000 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
$1,000

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 We do not publish dosing guidance: use the amount from your own prescription or treatment plan.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 6 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$1,000 to $1,175
FacilityA hospital or hospital-owned outpatient department$1,000$1,000 to $1,230

How much rates vary

Facilitymedian $1,000 · 10th to 90th $1,000 to $1,585Professionalmedian $1,000 · 10th to 90th $977 to $1,230
$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0Kfacility $1,000professional $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
$1,000.00
Median
$1,000.00
Typical High
$1,230.27
Aetna
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,000.00
Typical High
$1,230.27
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$3,162.28
Typical High
$3,162.28
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,071.52
Typical High
$1,071.52
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$1,584.89
Typical High
$2,454.71
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,174.90
Medcost
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$977.24
Typical High
$977.24
United
Setting
Professional
Modifier
Global
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$1,548.82
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$5,248.07
Median
$5,248.07
Typical High
$5,248.07

Where North Carolina sits

The same service costs 263026.8 times more in Alabama than in Indiana. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

North Carolina $1,000 · 35th of 51
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.