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Maryland rates for HCPCS J1303

Injection, ravulizumab-cwvz, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.19 / $225.19 / $247.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $288.24
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $225.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $286.69
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $235.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $238.62
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.59 / $220.59 / $220.59