CareCost Estimate
The Infusion Reimbursement Index · Q2 2026 · v2.0

Syfovre (J2781): what insurers contract to pay

Pegcetacoplan · Ophthalmology

CareCost Research · Reviewed by Erin Rose

Syfovre (J2781) carries a median commercial contracted rate of 96.2 on the Medicare ASP=100 index — 6.3% below the 102.7 typical-acquisition benchmark and 7.8% below the 104.3 Medicare payment line. 51 insurers report contracted rates across 52 states (902 priced cells), covering $339M in modeled Part B spend. It ranks #5 of 25 on the CareCost Buy-and-Bill Risk List, with a risk score of 79.5 out of 100.

Contracted rate range across insurers

90100110120130100 ASP102.7 acquisition104.3 Medicare

Shaded band: 10th–90th percentile across insurers. Darker band: 25th–75th percentile. Solid tick: median. Dashed lines: 100 (Medicare ASP), 102.7 (typical acquisition cost), 104.3 (Medicare payment after sequestration).

What each insurer contracts to pay

All 41 insurers with published rates for this code, ranked highest to lowest. Index is a multiple of Medicare ASP (ASP=100).

InsurerIndexvs. acquisitionPracticesStates
BlueCross BlueShield of South Carolina126.0+22.7%556
BlueCross BlueShield of Nebraska104.9+2.1%347
Anthem Massachusetts103.0+0.3%6425
HMSA (BCBS Hawaii)103.0+0.3%694
Kaiser Permanente102.5−0.2%3128
Blue Cross of Idaho101.9−0.8%676
BlueCross BlueShield of Kansas101.0−1.7%605
Premera Blue Cross100.7−1.9%1039
BCBS North Dakota100.6−2.0%1393
BlueCross BlueShield of Arkansas100.5−2.1%4821
BlueCross BlueShield of Louisiana100.0−2.6%547
BlueCross BlueShield of Texas100.0−2.6%393
Harvard Pilgrim Health Care99.2−3.4%22910
Anthem Wisconsin99.2−3.4%1545
Anthem Missouri99.2−3.4%428
Anthem Kentucky99.2−3.4%928
Blue Cross NC98.7−3.9%16448
Horizon BCBS of New Jersey96.7−5.8%446
Capital Blue Cross96.2−6.3%9235
Aetna96.0−6.5%74151
Anthem Virginia96.0−6.5%6319
Blue Shield of California94.4−8.1%1124
BlueCross BlueShield of Tennessee93.4−9.1%6110
Wellmark BCBS (Iowa/South Dakota)93.4−9.1%7810
BlueCross BlueShield of Minnesota93.4−9.1%586
Anthem California93.1−9.3%644
BlueCross BlueShield of Alabama92.7−9.7%916
CareFirst BlueCross BlueShield92.7−9.7%5918
Anthem New York92.7−9.7%7215
Anthem Nevada92.7−9.7%1944
UnitedHealthcare92.7−9.7%1,08051
Anthem Indiana92.7−9.7%14124
Cigna92.7−9.7%1,22551
Florida Blue92.7−9.7%325
Anthem Connecticut92.7−9.7%665
BlueCross BlueShield of Rhode Island92.7−9.7%2913
Anthem Georgia92.7−9.7%6915
Anthem Ohio92.7−9.7%7813
Anthem New Hampshire92.7−9.7%1465
Anthem Maine86.9−15.4%1223
BlueCross BlueShield of Arizona77.9−24.1%3819

The price history

Medicare's payment limit for Syfovre moved -3.7% between Q4 2023 and Q2 2026. Because contracted rates are set as a multiple of ASP, a falling denominator drags every contracted rate down with it, typically with a two-quarter lag as CMS updates the published benchmark.

$136$146$156Q4 2023: $153.52Q3 2026: $148.94

Solid dots: finalized CMS ASP quarters. Hollow dots: preliminary. Values are the Medicare payment limit (ASP + 6%, pre-sequestration) per billing unit.

Part B utilization

YearPart B spendDosage units (M)
2023$77M0.5
2024$404M
2025$339M

Where it pays most and least

Highest-paying statesIndexInsurers
Alaska (AK)118.86
Nebraska (NE)103.08
Hawaii (HI)102.57
Kansas (KS)101.010
Washington (WA)100.712
Lowest-paying statesIndexInsurers
North Dakota (ND)93.16
Nevada (NV)92.910
Delaware (DE)92.77
Maryland (MD)92.712
Tennessee (TN)92.717

What this means in dollars

At the median contracted rate, this code models a −$6,345 shortfall per $100,000 of acquisition-benchmark drug cost purchased — illustrative modeled margin exposure, not a claim about any single practice's actual reimbursement.

Based on 902 priced contract cells across 51 insurers and 52 states. These are insurers' contracted rates from published machine-readable files — not amounts actually paid on a claim, and not a guarantee of coverage or reimbursement. CareCost Estimate Infusion Reimbursement Index, Issue 01 (Q2 2026), v2.0. CC-BY 4.0. A drug-specific acquisition estimate exists in our warehouse but derives from ASP itself, so we do not print it — the flat 102.7 ODACS benchmark is the honest comparator here.