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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
$246.05 / $1,466.01 / $168,562.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $524.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $225.11
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$598.74 / $598.74 / $598.74
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $724.85
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$332.96 / $358.62 / $563.54
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$333.90 / $512.32 / $845.33
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $244.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $337.67 / $454.09