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Ocriplasmin Injection

Tennessee rates for HCPCS J7316

Injection, ocriplasmin, 0.125 mg

Rates data updated October 2026.

How much does Ocriplasmin Injection cost?

$1,175per 0.125 mg

Typical physician fee. In Tennessee, October 2026.

Insurers have agreed to pay about $1,175 for each 0.125 mg of this drug. Most negotiated rates run $1,047 to $1,230.

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

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 We do not publish dosing guidance: use the amount from your own prescription or treatment plan.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 3 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $1,288 · 10th to 90th $1,148 to $1,862Professionalmedian $1,047 · 10th to 90th $977 to $1,175
$1K$2Kfacility $1,288professional $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
$977.24
Median
$1,230.27
Typical High
$1,479.11
Aetna
Setting
Professional
Modifier
None
Typical Low
$977.24
Median
$977.24
Typical High
$977.24
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$489.78
Median
$489.78
Typical High
$489.78
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$97.72
Median
$97.72
Typical High
$97.72
Cigna
Setting
Facility
Modifier
None
Typical Low
$1,148.15
Median
$1,288.25
Typical High
$1,862.09
Cigna
Setting
Professional
Modifier
None
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,047.13
United
Setting
Professional
Modifier
None
Typical Low
$1,000.00
Median
$1,174.90
Typical High
$1,174.90

Where Tennessee 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.

Tennessee· 11th of 51

$1,175

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.