go back

Texas rates for HCPCS J1303

Injection, ravulizumab-cwvz, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $436.52 / $239,883.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $281.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $549.54 / $1,071.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $223.87
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $331.13 / $107,151.93
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72,443.60 / $72,443.60 / $72,443.60
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
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $1,122.02 / $1,122.02
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $316.23 / $776.25
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $281.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $218.78 / $223.87
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $323.59 / $707.95
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $223.87
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 / $223.87