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Ocriplasmin Injection

Texas 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 Texas, 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 $1,380 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
$1,380

The same drug, in the same amount, costs 32% 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 We do not publish dosing guidance: use the amount from your own prescription or treatment plan.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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,047$977 to $1,175
FacilityA hospital or hospital-owned outpatient department$1,380$1,047 to $2,291

How much rates vary

Facilitymedian $1,380 · 10th to 90th $977 to $3,311Professionalmedian $1,047 · 10th to 90th $955 to $1,175
$1K$2K$5K$10Kfacility $1,380professional $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
$1,513.56
Typical High
$2,041.74
Aetna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$489.78
Median
$741.31
Typical High
$1,023.29
Aetna
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$194.98
Median
$302.00
Typical High
$407.38
Aetna
Setting
Facility
Modifier
55 · Aftercare only
Typical Low
$144.54
Median
$223.87
Typical High
$309.03
Aetna
Setting
Facility
Modifier
56 · Pre-op care only
Typical Low
$97.72
Median
$151.36
Typical High
$204.17
Aetna
Setting
Professional
Modifier
None
Typical Low
$954.99
Median
$977.24
Typical High
$1,122.02
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$478.63
Median
$489.78
Typical High
$562.34
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$190.55
Median
$194.98
Typical High
$223.87
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$141.25
Median
$144.54
Typical High
$169.82
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$95.50
Median
$97.72
Typical High
$112.20
Cigna
Setting
Facility
Modifier
None
Typical Low
$1,047.13
Median
$1,584.89
Typical High
$3,311.31
Cigna
Setting
Professional
Modifier
None
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,047.13
Moda Health
Setting
Facility
Modifier
None
Typical Low
$977.24
Median
$1,202.26
Typical High
$2,290.87
Moda Health
Setting
Professional
Modifier
None
Typical Low
$954.99
Median
$977.24
Typical High
$977.24
Moda Health
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$478.63
Median
$489.78
Typical High
$489.78
Moda Health
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$190.55
Median
$194.98
Typical High
$194.98
Moda Health
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$141.25
Median
$144.54
Typical High
$144.54
Moda Health
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$95.50
Median
$97.72
Typical High
$97.72
Providence
Setting
Facility
Modifier
None
Typical Low
$977.24
Median
$1,258.93
Typical High
$8,912.51
Providence
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
$1,174.90
Median
$1,174.90
Typical High
$1,174.90
Wellpoint
Setting
Professional
Modifier
None
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,047.13

Where Texas 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.

Texas· 39th 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.