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Maine rates for HCPCS J1303

Injection Ravulizumab-Cwvz 10 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$522.26 / $522.26 / $562.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $234.20 / $309.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$217.84 / $273.44 / $713.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $225.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.11 / $225.11 / $225.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $225.11
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $272.61
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$522.26 / $522.26 / $562.78
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $258.87 / $562.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $326.41