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Arizona rates for HCPCS J1303

Injection, ravulizumab-cwvz, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$240.87 / $450.22 / $675.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $272.48 / $592.85
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$195.92 / $778.48 / $1,196.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.62 / $213.27 / $1,432.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.36 / $225.11 / $225.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $225.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.00 / $293.07 / $354.23
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.19 / $225.19 / $225.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$224.97 / $224.97 / $224.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $225.11