go back

South Carolina 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
$1,198.94 / $1,360.02 / $2,742.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$820.32 / $1,596.74 / $2,702.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,042.98 / $1,185.20 / $1,422.24
Cigna
Facility/Professional
Facility
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 / $1,046.93
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,185.20 / $1,185.20 / $1,185.20
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,832.13 / $1,832.13 / $1,832.13
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$971.86 / $971.86 / $1,214.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,185.20 / $1,185.20 / $1,185.20