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Nebraska 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 / $78.93 / $174.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.43 / $78.93 / $131.62
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.02 / $84.89 / $89.36
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.34 / $87.90 / $89.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.93 / $81.23 / $101.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.78 / $180.95 / $398.70
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.43 / $78.43 / $86.27
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.68 / $133.29 / $172.45
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.64 / $95.68 / $120.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.98 / $78.93 / $86.82