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Idaho rates for HCPCS J1303

Injection Ravulizumab-Cwvz 10 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.19 / $225.19 / $258.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $247.62 / $281.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$212.37 / $225.11 / $225.11
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
$247.62 / $298.26 / $402.37
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $281.39
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.11 / $225.11 / $332.82
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.47 / $270.13 / $270.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $225.11