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Maryland rates for HCPCS J2779

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.86 / $14,125.38 / $14,125.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $75.86 / $104.71
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $75.86 / $75.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $75.86 / $97.72
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $75.86 / $87.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.86 / $75.86 / $75.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $75.86 / $91.20
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $81.28 / $81.28