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Nebraska rates for HCPCS J0791

Injection, crizanlizumab-tmca, 5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$129.58 / $129.58 / $286.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.47 / $129.58 / $320.70
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.94 / $139.25 / $146.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.25 / $145.11 / $146.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.47 / $131.93 / $164.91
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$127.10 / $129.58 / $647.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.47 / $129.58 / $142.54
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.41 / $207.17 / $302.39
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.16 / $155.49 / $319.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.53 / $129.47 / $142.43