go back

Ocriplasmin Injection

Pennsylvania 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 Pennsylvania, 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 $1,514 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
$1,514

The same drug, in the same amount, costs 51% 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 We do not publish dosing guidance: use the amount from your own prescription or treatment plan.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 7 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 $1,000
FacilityA hospital or hospital-owned outpatient department$1,514$1,072 to $2,570

How much rates vary

Facilitymedian $1,514 · 10th to 90th $1,000 to $2,951Professionalmedian $1,000 · 10th to 90th $1,000 to $1,175
$1.0K$2.0K$5.0K$10.0K$20.0K$50.0Kfacility $1,514professional $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
$1,513.56
Typical High
$2,951.21
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,000.00
Typical High
$1,000.00
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$977.24
Typical High
$8,511.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$977.24
Typical High
$977.24
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$3,630.78
Typical High
$3,890.45
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,047.13
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,047.13
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$1,513.56
Typical High
$2,818.38
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,000.00
Typical High
$2,570.40
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$3,388.44
Median
$3,388.44
Typical High
$3,388.44
United
Setting
Professional
Modifier
Global
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$1,621.81

Where Pennsylvania 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.

Pennsylvania $1,000 · 36th 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.