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South Carolina rates for HCPCS J1303

Injection, ravulizumab-cwvz, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.42 / $954.99 / $151,356.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $363.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $269.15 / $489.78
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $269.15 / $295.12
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 / $223.87
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.42 / $263.03 / $630.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $223.87 / $478.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $223.87 / $245.47