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Wyoming rates for HCPCS J1303

Injection, ravulizumab-cwvz, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $223.87 / $223.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $229.09 / $380.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $269.15 / $269.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $213.80 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $316.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $223.87 / $436.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $223.87