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Wisconsin rates for HCPCS J2777

Injection Faricimab-Svoa 0.1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.89 / $68.95 / $79.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $34.89 / $2,335.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.35 / $62.68 / $75.55
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $33.88 / $45.73
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.88 / $46.38 / $51.72
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $34.47 / $78.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.88 / $68.47 / $118.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $43.15 / $63.96
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.88 / $34.54 / $40.65
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.72 / $67.76 / $67.76
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.47 / $34.82 / $38.36
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.47 / $34.47 / $155.61
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.44 / $65.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.88 / $34.47 / $40.65
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.72 / $67.76 / $67.76
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $52.73 / $117.79
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.88 / $33.88 / $173.60
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $64.84 / $155.61
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.57 / $47.57 / $61.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $33.88 / $44.04