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Arizona rates for HCPCS J2779

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.65 / $141.25 / $269.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $79.43 / $204.17
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.65 / $144.54 / $295.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $144.54 / $354.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.86 / $75.86 / $75.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $75.86 / $75.86
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.62 / $104.71 / $123.03
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $77.62 / $77.62
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $79.43 / $131.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $75.86 / $79.43