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Illinois rates for HCPCS J1303

Injection, ravulizumab-cwvz, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.19 / $364.68 / $792.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.19 / $292.75
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.64 / $961.45 / $4,764.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.11 / $225.11 / $225.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $225.11
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.34 / $261.27 / $506.90
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.64 / $292.64 / $292.64
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 / $238.84