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Indiana rates for HCPCS J2779

Injection Ranibizumab Via Intravitreal Implant (Susvimo) 0.1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.22 / $189.79 / $356.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.93 / $79.72 / $79.72
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.93 / $157.86 / $209.16
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.09 / $78.93 / $112.08
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.93 / $78.93 / $113.40
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.93 / $78.93 / $98.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.93 / $78.93 / $78.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.93 / $78.93 / $217.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.93 / $78.93 / $97.87