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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
$229.61 / $261.27 / $526.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $229.61 / $274.33
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.11 / $382.69 / $808.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $281.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$212.37 / $212.37 / $225.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $225.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.19 / $270.13 / $1,131.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.41 / $225.19 / $256.05
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$224.97 / $224.97 / $224.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.34 / $225.11 / $256.05