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Indiana rates for HCPCS J1303

Injection, ravulizumab-cwvz, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$227.36 / $529.79 / $1,023.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $227.36 / $227.36
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.11 / $450.22 / $596.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.34 / $225.11 / $319.64
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.11 / $225.11 / $308.64
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $281.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.11 / $225.11 / $606.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.68 / $225.11 / $607.05
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 / $279.14