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Ocriplasmin Injection

Pennsylvania rates for HCPCS J7316

Injection, ocriplasmin, 0.125 mg

Rates data updated October 2026.

How much does Ocriplasmin Injection cost?

$1,047per 0.125 mg

Typical negotiated rate. In Pennsylvania, October 2026.

Insurers have agreed to pay about $1,047 for each 0.125 mg of this drug. The price depends on where it is billed: about $1,047 from a physician practice, and about $1,445 from a hospital or other facility.

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
$1,047
At a hospital outpatient department
$1,445

The same drug, in the same amount, costs 38% 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 We do not publish dosing guidance: use the amount from your own prescription or treatment plan.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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,047$1,000 to $1,175
FacilityA hospital or hospital-owned outpatient department$1,445$1,000 to $3,802

How much rates vary

Facilitymedian $1,445 · 10th to 90th $912 to $3,981Professionalmedian $1,047 · 10th to 90th $1,000 to $1,259
$1K$2K$5Kfacility $1,445professional $1,047

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$1,000.00
Median
$1,000.00
Typical High
$1,513.56
Aetna
Setting
Professional
Modifier
None
Typical Low
$1,000.00
Median
$1,000.00
Typical High
$1,000.00
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$501.19
Median
$501.19
Typical High
$501.19
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$151.36
Median
$151.36
Typical High
$151.36
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Capital Blue Cross
Setting
Facility
Modifier
None
Typical Low
$870.96
Median
$977.24
Typical High
$5,011.87
Capital Blue Cross
Setting
Professional
Modifier
None
Typical Low
$977.24
Median
$977.24
Typical High
$977.24
Cigna
Setting
Facility
Modifier
None
Typical Low
$1,047.13
Median
$1,737.80
Typical High
$3,981.07
Cigna
Setting
Professional
Modifier
None
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,047.13
Geisinger
Setting
Professional
Modifier
None
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,047.13
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$1,000.00
Median
$1,479.11
Typical High
$1,513.56
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$1,000.00
Median
$1,000.00
Typical High
$1,000.00
Martin's Point
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$501.19
Median
$501.19
Typical High
$501.19
Martin's Point
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
Martin's Point
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$151.36
Median
$151.36
Typical High
$151.36
Martin's Point
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
UPMC Health Plan
Setting
Facility
Modifier
None
Typical Low
$3,548.13
Median
$3,548.13
Typical High
$3,548.13
United
Setting
Professional
Modifier
None
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$1,621.81

Where Pennsylvania sits

The same service costs 5.8 times more in Alabama than in Arkansas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 45th of 51

$1,047

AL $5,623AR $977

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.