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Tennessee rates for HCPCS J1303

Injection, ravulizumab-cwvz, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $225.11 / $490.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $272.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.11 / $225.11 / $225.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $225.11
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$293.07 / $1,131.40 / $1,131.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$224.97 / $224.97 / $224.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.09 / $225.11 / $225.11