Cost analysis for CPT J1306 — Injection, inclisiran, 1 mg
Average Medicare Payment
$9.37
2023 data
Total Payments (2023)
$57.1M
Services (2023)
6.1M
Price Change (2022–2023)
-0.5%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2022 | $9.42 | $9.7M | 1.0M | — |
| 2023 | $9.37 | $57.1M | 6.1M | -0.5% |
The most expensive state pays 1.1x more than the cheapest for this procedure. WA averages $9.41 vs HI at $8.73.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| WA | $9.41 | $53.5K | 5.7K | 1 |
| MN | $9.41 | $131.0K | 13.9K | 1 |
| OR | $9.41 | $304.7K | 32.4K | 3 |
| NC | $9.40 | $977.4K | 103.9K | 10 |
| NJ | $9.40 | $1.3M | 135.7K | 11 |
| CT | $9.40 | $160.2K | 17.0K | 2 |
| KY | $9.40 | $229.5K | 24.4K | 2 |
| MD | $9.40 | $1.7M | 180.9K | 15 |
| UT | $9.39 | $535.8K | 57.0K | 6 |
| AR | $9.39 | $144.0K | 15.3K | 3 |
| IA | $9.39 | $458.8K | 48.9K | 5 |
| MI | $9.39 | $258.7K | 27.5K | 4 |
| AZ | $9.39 | $3.4M | 359.8K | 15 |
| SC | $9.39 | $1.8M | 192.6K | 19 |
| OH | $9.38 | $1.2M | 124.4K | 14 |
| CO | $9.38 | $1.1M | 122.1K | 8 |
| ID | $9.38 | $399.6K | 42.6K | 1 |
| GA | $9.38 | $2.9M | 312.4K | 11 |
| IN | $9.37 | $165.1K | 17.6K | 2 |
| NE | $9.37 | $364.7K | 38.9K | 2 |
| FL | $9.37 | $5.6M | 601.8K | 49 |
| IL | $9.37 | $1.6M | 175.5K | 19 |
| CA | $9.37 | $8.9M | 953.5K | 60 |
| LA | $9.37 | $1.3M | 140.0K | 12 |
| TX | $9.37 | $5.7M | 610.6K | 50 |
| MO | $9.37 | $614.8K | 65.6K | 10 |
| MT | $9.37 | $141.0K | 15.1K | 1 |
| MA | $9.36 | $130.3K | 13.9K | 1 |
| WI | $9.36 | $707.1K | 75.5K | 2 |
| NV | $9.36 | $768.1K | 82.1K | 6 |
| KS | $9.35 | $398.4K | 42.6K | 5 |
| PA | $9.35 | $2.3M | 248.8K | 15 |
| AL | $9.34 | $1.4M | 148.0K | 11 |
| NY | $9.34 | $1.6M | 174.8K | 15 |
| TN | $9.33 | $3.4M | 361.9K | 38 |
| VA | $9.33 | $1.3M | 144.7K | 6 |
| OK | $9.32 | $1.3M | 141.4K | 4 |
| MS | $9.32 | $1.3M | 142.9K | 18 |
| DE | $9.24 | $719.9K | 77.9K | 4 |
| HI | $8.73 | $59.5K | 6.8K | 1 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Janice Mcalister | Nurse Practitioner | GA | $1.5M | 155.1K | $9.38 |
| Samuel Ganz | Internal Medicine | FL | $947.2K | 100.8K | $9.40 |
| Wendy Prewett | Nurse Practitioner | TX | $944.4K | 100.8K | $9.37 |
| Gregory Cowan | Allergy/ Immunology | AZ | $920.6K | 98.3K | $9.37 |
| Afshine Emrani | Cardiology | CA | $862.3K | 91.4K | $9.43 |
| Jodi Bond | Nurse Practitioner | AZ | $846.9K | 90.0K | $9.41 |
| Robert Singh | Vascular Surgery | PA | $785.6K | 84.6K | $9.28 |
| Jeffrey Weber | Gastroenterology | WI | $651.1K | 69.6K | $9.36 |
| Celine Byrnes | Nurse Practitioner | CA | $626.8K | 66.5K | $9.42 |
| Kheni Brasso | Nurse Practitioner | OK | $603.9K | 64.5K | $9.37 |
| Stephanie Geier | Nurse Practitioner | AZ | $526.8K | 55.9K | $9.42 |
| Jonathan Wiesen | Pulmonary Disease | VA | $511.1K | 55.2K | $9.25 |
| Stephen Corday | Cardiology | CA | $503.6K | 53.7K | $9.38 |
| Lourdes Aponte | Internal Medicine | DE | $499.0K | 53.7K | $9.29 |
| Lori Craig | Nurse Practitioner | OK | $491.0K | 53.1K | $9.25 |
| Matthew Marx | Nurse Practitioner | NJ | $447.7K | 47.7K | $9.38 |
| Chiayu Chen | Cardiology | CA | $431.9K | 46.3K | $9.33 |
| Jodie Gallegos | Nurse Practitioner | CO | $431.7K | 46.0K | $9.38 |
| Julie Hampton | Nurse Practitioner | TX | $431.0K | 46.0K | $9.36 |
| Jacqueline Channell | Nurse Practitioner | CA | $409.4K | 43.7K | $9.36 |
Based on the data, CPT J1306 shows a 1.1x variation in pricing across states — relatively consistent by Medicare standards.
Costs have decreased 0.5% since 2022. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.