go back

Washington rates for HCPCS J1303

Injection, ravulizumab-cwvz, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$246.05 / $380.39 / $470.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $242.73 / $309.14
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.11 / $270.13 / $536.69
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $233.07 / $261.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$212.37 / $212.37 / $440.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $276.07
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.11 / $281.39 / $468.40
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.60 / $354.84 / $620.96
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.42 / $239.31 / $256.16
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$221.21 / $247.62 / $442.42
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $225.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$224.97 / $224.97 / $224.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.11 / $225.11 / $225.11