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 INTRAVENOUS SOLUTION
Goldsboro, NC
See all hospitals reporting HCPCS J1303 →Price type
Wayne Memorial Hospital’s median price of $5.2k is 1349% above the median hospital's median price ($360), higher than 78% 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, 21 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.
Filter by billing methodology
Filter by billing class
| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield medicare advantage facility · fee schedule · outpatient | $218 | $218 | — | — | — | $218 – $218 |
| 2 | Optum vaccn facility · fee schedule · outpatient | $225 | $225 | — | — | — | $225 – $225 |
| 3 | Humana medicare hmo facility · fee schedule · outpatient | $230 | $230 | — | — | — | $230 – $230 |
| 4 | Humana medicare ppo facility · fee schedule · outpatient | $230 | $230 | — | — | — | $230 – $230 |
| 5 | Cigna medicare advantage facility · fee schedule · outpatient | $236 | $236 | — | — | — | $236 – $236 |
| 6 | UnitedHealthcare medicare advantage facility · fee schedule · outpatient | $236 | $236 | — | — | — | $236 – $236 |
| 7 | Aetna medicare advantage facility · fee schedule · outpatient | $239 | $239 | — | — | — | $239 – $239 |
| 8 | Cigna commercial facility · fee schedule · outpatient | $507 | $507 | — | — | — | $507 – $507 |
| 9 | UnitedHealthcare commercial facility · fee schedule · outpatient | $613 | $613 | — | — | — | $613 – $613 |
| 10 | UnitedHealthcare individual exchange facility · fee schedule · outpatient | $613 | $613 | — | — | — | $613 – $613 |
| 11 | Amerihealth Caritas managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $12.1k | $12.1k | $6.9k | 57% | — | $5.2k – $19.0k |
| 12 | UnitedHealthcare chip/medicaid facility · percent of total billed charges · outpatientfrom % of charges | $12.1k | $12.1k | $6.9k | 57% | — | $5.2k – $19.0k |
| 13 | WellCare managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $12.1k | $12.1k | $6.9k | 57% | — | $5.2k – $19.0k |
| 14 | Aetna north carolina preferred facility · percent of total billed charges · outpatientfrom % of charges | $34.9k | $34.9k | $19.9k | 57% | — | $15.0k – $54.8k |
| 15 | Blue Cross Blue Shield blue select/blue value/hmo/ppo facility · fee schedule · outpatient | $36.1k | $36.1k | — | — | — | $36.1k – $36.1k |
| 16 | Cigna commercial facility · percent of total billed charges · inpatientfrom % of charges | $36.1k | $36.1k | $20.6k | 57% | — | $15.5k – $56.7k |
| 17 | UnitedHealthcare individual exchange facility · percent of total billed charges · inpatientfrom % of charges | $36.2k | $36.2k | $20.7k | 57% | — | $15.5k – $56.9k |
| 18 | UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges | $38.1k | $38.1k | $21.8k | 57% | — | $16.4k – $59.9k |
| 19 | Medcost commercial/ultra facility · percent of total billed charges · outpatientfrom % of charges | $39.8k | $39.8k | $22.7k | 57% | — | $17.1k – $62.5k |
| 20 | Medcost commercial/ultra facility · percent of total billed charges · inpatientfrom % of charges | $40.3k | $40.3k | $23.0k | 57% | — | $17.3k – $63.3k |
| 21 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $42.3k | $42.3k | $24.1k | 57% | — | $18.1k – $66.4k |
Last updated: Jun 18, 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.