go back

Michigan rates for HCPCS J1303

Injection, ravulizumab-cwvz, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $645.65 / $91,201.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $229.09 / $281.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $363.08 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $223.87
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $602.56 / $724.44
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $234.42 / $309.03
Priority Health
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 / $223.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $239.88