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Washington rates for HCPCS J1303

Injection, ravulizumab-cwvz, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $389.05 / $537.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $229.09 / $309.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $213.80 / $436.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $275.42
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $281.84 / $426.58
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.53 / $257.04 / $616.60
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $239.88 / $257.04
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $245.47 / $489.78
Regence BlueShield
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
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $295.12