Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
ravulizumab-cwvz 100 mg/mL Soln 3 mL VIAL
Rapids, MN
See all hospitals reporting HCPCS J1303 →Price type
Allina Health Systems’s median price of $2.2k is 515% above the median hospital's median price ($360), higher than 75% of the 1,650 hospitals reporting HCPCS J1303. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 28 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare united healthcare (um) facility · case rate · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 2 | Medicaid medicaid ma (m) facility · fee schedule · outpatient | $203 | $203 | — | — | — | $203 – $203 |
| 3 | Aetna allina aetna medicare (m) facility · fee schedule · outpatient | $214 | $214 | — | — | — | $214 – $214 |
| 4 | Bcbs Mn bc pmap (amu) facility · other · outpatient | $224 | $224 | — | — | — | $224 – $224 |
| 5 | Medicare medicare (m) facility · fee schedule · outpatient | $225 | $225 | — | — | — | $225 – $225 |
| 6 | Medica medica medicare (m) facility · fee schedule · outpatient | $234 | $234 | — | — | — | $234 – $234 |
| 7 | Blue Cross Blue Shield bc medicare (m) facility · fee schedule · outpatient | $236 | $236 | — | — | — | $236 – $236 |
| 8 | Bcbs Mn bc premier (m u) facility · other · outpatient | $253 | $253 | — | — | — | $253 – $253 |
| 9 | UnitedHealthcare uhc ubh pmap (m) facility · other · outpatient | $254 | $254 | — | — | — | $254 – $254 |
| 10 | Blue Cross Blue Shield bc aehp (mu) facility · other · outpatient | $298 | $298 | — | — | — | $298 – $298 |
| 11 | Bcbs Mn bc state health plan (mu) facility · other · outpatient | $304 | $304 | — | — | — | $304 – $304 |
| 12 | Bcbs Mn bc high value/performance network (mu) facility · other · outpatient | $320 | $320 | — | — | — | $320 – $320 |
| 13 | Ucare ucare pmap (abdmnorsuv) facility · percent of total billed charges · outpatientfrom % of charges | $8.8k | $8.8k | $5.0k | 57% | — | $3.8k – $13.7k |
| 14 | Medica medica pmap (um) facility · percent of total billed charges · outpatientfrom % of charges | $9.7k | $9.7k | $5.5k | 57% | — | $4.2k – $15.2k |
| 15 | Aetna aetna elevate (amu) facility · percent of total billed charges · outpatientfrom % of charges | $15.3k | $15.3k | $8.7k | 57% | — | $6.6k – $24.1k |
| 16 | Aetna aetna performance (amu) facility · percent of total billed charges · outpatientfrom % of charges | $16.3k | $16.3k | $9.3k | 57% | — | $7.0k – $25.6k |
| 17 | Medica medica dual solutions (m) facility · percent of total billed charges · outpatientfrom % of charges | $19.3k | $19.3k | $11.0k | 57% | — | $8.3k – $30.3k |
| 18 | Aetna aetna direct network (amu) facility · percent of total billed charges · outpatientfrom % of charges | $23.8k | $23.8k | $13.5k | 57% | — | $10.2k – $37.3k |
| 19 | Bcbs Mn bc aware/blue plus (a m u) facility · percent of total billed charges · outpatientfrom % of charges | $25.5k | $25.5k | $14.5k | 57% | — | $11.0k – $40.1k |
| 20 | Medica medica ubh (m) facility · percent of total billed charges · inpatientfrom % of charges | $30.5k | $30.5k | $17.3k | 57% | — | $13.1k – $47.8k |
| 21 | Medica medica elect (u m) facility · percent of total billed charges · outpatientfrom % of charges | $31.2k | $31.2k | $17.8k | 57% | — | $13.4k – $49.0k |
| 22 | Medica medica essentials (u m) facility · percent of total billed charges · outpatientfrom % of charges | $32.6k | $32.6k | $18.5k | 57% | — | $14.0k – $51.1k |
| 23 | Medica medica mhps (u m) facility · percent of total billed charges · outpatientfrom % of charges | $32.6k | $32.6k | $18.5k | 57% | — | $14.0k – $51.1k |
| 24 | Medica medica choice (u m) facility · percent of total billed charges · outpatientfrom % of charges | $34.3k | $34.3k | $19.5k | 57% | — | $14.8k – $53.8k |
| 25 | Medica medica ubh pmap (m) facility · percent of total billed charges · outpatientfrom % of charges | $34.8k | $34.8k | $19.8k | 57% | — | $15.0k – $54.6k |
Last updated: Jun 17, 2026
See Ravulizumab injection (Ultomiris), per 10 mg pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.