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Michigan rates for HCPCS J1303

Injection Ravulizumab-Cwvz 10 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$231.86 / $231.95 / $91,103.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $231.86 / $272.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$261.50 / $490.97 / $935.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $234.82
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.11 / $278.33 / $723.68
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $231.86 / $270.13
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$253.36 / $258.87 / $258.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$224.97 / $224.97 / $224.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $270.13