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Missouri rates for HCPCS J1303

Injection, ravulizumab-cwvz, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $263.03 / $64,565.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $234.42 / $363.08
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $239.88 / $794.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $263.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $223.87 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $229.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $269.15 / $1,122.02
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $223.87 / $257.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $269.15 / $295.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $223.87 / $263.03