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Utah rates for HCPCS J2779

Injection Ranibizumab Via Intravitreal Implant (Susvimo) 0.1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.98 / $91.56 / $91.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.56 / $91.56 / $91.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$94.13 / $113.81 / $122.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.93 / $78.93 / $78.93
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.38 / $162.59 / $233.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.98 / $78.93 / $78.93