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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
$346.74 / $426.58 / $1,348.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $234.42 / $616.60
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $616.60 / $912.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $426.58 / $1,047.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $223.87 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $223.87
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $295.12 / $354.81
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $223.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $223.87 / $363.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $223.87 / $223.87