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Nebraska rates for HCPCS J1303

Injection, ravulizumab-cwvz, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.19 / $432.68 / $497.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $592.85
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$216.61 / $254.84 / $72,824.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.09 / $252.28 / $254.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$274.00 / $274.00 / $274.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$224.48 / $225.11 / $280.58
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$224.16 / $427.86 / $1,131.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.32 / $225.19 / $247.71
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$264.38 / $339.29 / $465.72
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$253.97 / $270.23 / $577.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$224.97 / $224.97 / $224.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.85 / $225.11 / $247.62