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Montana rates for HCPCS J2779

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

Facilitymedian $87 · 10th–90th $85–$1580%50%10th90th$87Professionalmedian $83 · 10th–90th $76–$2140%20%40%10th90th$83$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $83.18 / $213.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $91.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $91.20
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $87.10 / $245.47
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $87.10 / $245.47
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $91.20
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $83.18 / $107.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $75.86