go back

Georgia rates for HCPCS J1303

Injection, ravulizumab-cwvz, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $141,253.75 / $309,029.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $229.09 / $331.13
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $363.08 / $1,230.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $223.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $213.80 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $223.87
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $794.33 / $851.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $426.58 / $602.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $281.84