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Washington rates for HCPCS Q5124

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.98 / $123.60 / $129.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.79 / $67.98 / $235.95
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$157.71 / $236.57 / $488.90
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.80 / $101.97 / $279.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.28 / $55.28 / $61.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.80 / $61.80 / $71.86
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.65 / $62.15 / $157.71
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$168.76 / $300.02 / $525.03
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.00 / $183.56 / $279.33
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$157.71 / $220.83 / $351.14
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.80 / $61.80 / $61.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.80 / $61.80 / $85.57