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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
$223.87 / $389.05 / $831.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $331.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $912.01 / $4,570.88
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
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $302.00 / $501.19
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
$295.12 / $295.12 / $295.12
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $223.87 / $363.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $239.88