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West Virginia rates for HCPCS J0791

Injection, crizanlizumab-tmca, 5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$129.58 / $129.58 / $130.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.47 / $130.77 / $177.81
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$129.47 / $194.22 / $194.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.15 / $129.47 / $129.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.47 / $129.47 / $240.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.60 / $129.47 / $147.18