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Utah rates for HCPCS J1303

Injection, ravulizumab-cwvz, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$261.12 / $261.12 / $90,110.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$261.12 / $261.12 / $261.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$256.69 / $291.33 / $335.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $225.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.11 / $225.11 / $599.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.85 / $225.11 / $225.11