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Alaska rates for HCPCS J2779

Injection, ranibizumab, via intravitreal implant (Susvimo), 0.1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.39 / $144.41 / $510.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.22 / $87.69 / $182.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.93 / $78.93 / $78.93
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$209.95 / $209.95 / $209.95
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.93 / $78.93 / $254.15
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.46 / $134.40 / $211.20
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.49 / $192.00 / $316.80
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.93 / $78.93 / $85.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.93 / $118.40 / $159.22