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Pennsylvania rates for HCPCS J1303

Injection, ravulizumab-cwvz, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $562.34 / $229,086.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $229.09 / $316.23
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.93 / $245.47 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $234.42 / $245.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $223.87 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $223.87
Geisinger
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $223.87 / $223.87
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $389.05 / $389.05
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $275.42 / $275.42
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $562.34 / $234,422.88
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $229.09 / $630.96
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.11 / $257.04 / $263.03
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $257.04 / $263.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $223.87 / $223.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $309.03