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Oklahoma rates for HCPCS J1303

Injection Ravulizumab-Cwvz 10 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.19 / $243.21 / $413.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.12 / $243.12 / $243.12
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.70 / $193.51 / $306.88
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 / $243.21 / $347.79
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.32 / $225.19 / $225.19
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 / $229.61