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Pennsylvania rates for HCPCS C9093

Injection, ranibizumab, via sustained release intravitreal implant (Susvimo), 0.1 mg

Facilitymedian $105 · 10th–90th $81–$1050%50%10th$105Professionalmedian $81 · 10th–90th $76–$810%50%10th$81$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $104.71 / $104.71
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $81.28 / $81.28
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $81.28
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $81.28 / $81.28