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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
$128.82 / $128.82 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $128.82 / $141.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $128.82 / $194.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $549.54 / $549.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.82 / $128.82 / $128.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $128.82 / $147.91