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Idaho rates for HCPCS J2779

Injection Ranibizumab Via Intravitreal Implant (Susvimo) 0.1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.43 / $78.43 / $90.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.43 / $87.69 / $98.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.47 / $78.93 / $78.93
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
$86.83 / $104.59 / $141.10
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.93 / $78.93 / $98.66
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.73 / $79.73 / $79.73
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.54 / $120.74 / $208.08
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.72 / $94.72 / $98.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.93 / $78.93 / $78.93