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Alaska rates for HCPCS J1303

Injection, ravulizumab-cwvz, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,479.11 / $41,686.94 / $56,234.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $223.87
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $223.87 / $416.87
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $724.44
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $363.08 / $575.44
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $223.87
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $416.87 / $602.56
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $223.87 / $245.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $338.84 / $457.09