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Wisconsin rates for HCPCS J1300

Injection, eculizumab, 10 mg

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $549.54 / $812.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $302.00 / $407.38
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $407.38
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $1,148.15 / $1,148.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $223.87