go back

Maine rates for HCPCS 79101

Radiopharmaceutical therapy, by intravenous administration

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $151.36 / $331.13
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$41.69 / $57.54 / $125.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $208.93 / $257.04
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$50.12 / $75.86 / $91.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $245.47 / $363.08
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$67.61 / $95.50 / $131.83
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $213.80 / $407.38
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$66.07 / $77.62 / $151.36
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $204.17 / $588.84
Martin's Point
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$52.48 / $87.10 / $234.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $204.17 / $380.19
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$46.77 / $70.79 / $117.49