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Utah rates for HCPCS J2779

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

Facilitymedian $100 · 10th–90th $87–$2190%20%10th90th$100Professionalmedian $76 · 10th–90th $76–$910%20%40%90th$76$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
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $87.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $87.10 / $91.20
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $114.82 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $75.86
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $162.18 / $229.09
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $75.86 / $91.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $75.86