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Missouri 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 / $96.00 / $100.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.93 / $82.35 / $96.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.93 / $134.18 / $283.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.93 / $78.93 / $98.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.47 / $74.47 / $78.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.93 / $78.93 / $78.93
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $106.07 / $398.70
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.67 / $78.43 / $90.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.09 / $78.93 / $91.32