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Washington rates for HCPCS J0791

Injection Crizanlizumab-Tmca 5 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.82 / $165.73 / $269.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.47 / $142.43 / $177.81
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$127.10 / $155.38 / $307.58
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.47 / $135.96 / $148.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.15 / $122.15 / $259.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.47 / $129.47 / $158.80
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$127.39 / $129.57 / $244.72
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.39 / $203.36 / $355.89
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.26 / $139.61 / $148.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$127.39 / $142.43 / $254.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.47 / $129.47 / $129.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.47 / $129.47 / $129.47