Tersera Therapeutics

PRIALT - Cost

Last Updated: April 1st, 2024

HCPCS:

J2278

HCPCS Code Descriptor:

Injection, ziconotide, 1 microgram

Medicare Payment Limit:

The PRIALT Medicare Payment Limit is $9.041

Average Sale Price:

PRIALT ASP cost available once logged in.

Medicare Co-Insurance Percentage:

The PRIALT Medicare Co-insurance percentage is 20%. PRIALT's Medicare Co-insurance amount is $1.81 per HCPCS unit.

APC Code:

The Prialt APC Code is: 1694

APC Payment Limit:

The APC Payment Limit for PRIALT is available. Login to view.

Prialt Cost Information:

PRIALT, HCPCS J2278, became effective on January 1, 2006. PRIALT has three NDCs mapped to J Code: J2278 without issue. Between 2019 and 2024, pricing has risen slightly every six months. At the beginning of 2024, ASP trended nearly 20% below WAC and 30% below AWP.

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Prialt’s wholesale acquisition cost (WAC) information was last updated on:
January 1, 2024
Prialt’s average wholesale price (AWP) information was last updated on:
January 1, 2024