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Montana rates for HCPCS Q5124

Injection, ranibizumab-nuna, biosimilar, (Byooviz), 0.1 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $64.57 / $831.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $97.72 / $97.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $60.26 / $97.72
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $190.55 / $562.34
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $190.55 / $562.34
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $97.72 / $97.72
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $79.43 / $85.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $60.26 / $60.26