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Nebraska 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
$1,859.87 / $2,278.07 / $2,619.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,742.96 / $2,742.96 / $2,742.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$888.92 / $1,185.00 / $1,185.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,125.97 / $1,173.38 / $1,185.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,046.93 / $1,066.50 / $1,333.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,185.20 / $5,234.64 / $5,234.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,185.20 / $1,185.20 / $1,185.20
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,186.18 / $1,306.94 / $1,460.37
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,222.43 / $1,308.44 / $2,669.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,125.94 / $1,185.20 / $1,185.20