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South Carolina rates for HCPCS C9093

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.72 / $78.72 / $78.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.72 / $78.72 / $81.59
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00