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Louisiana rates for HCPCS J1303

Injection, ravulizumab-cwvz, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.11 / $231.95 / $497.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.19 / $272.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.35 / $190.48 / $220.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.00 / $220.00 / $224.40
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71,686.49 / $71,686.49 / $71,686.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$212.37 / $212.37 / $225.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $225.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.68 / $225.11 / $261.27