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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
$229.09 / $234.42 / $562.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $245.47
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $218.78 / $218.78
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $218.78 / $223.87
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72,443.60 / $72,443.60 / $72,443.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $213.80 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $223.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $223.87 / $234.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $223.87 / $245.47