go back

Massachusetts rates for HCPCS J1303

Injection, ravulizumab-cwvz, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $346.74 / $138,038.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $436.52
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $562.34 / $741.31
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $275.42
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $223.87 / $446.68
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
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $354.81 / $8,511.38
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $380.19
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $562.34 / $741.31
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $275.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $223.87 / $478.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $316.23