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Maine rates for HCPCS 80195

Sirolimus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.73 / $61.37 / $254.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.12 / $11.12 / $13.73
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.29 / $18.32 / $76.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.49 / $5.49 / $9.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.60 / $19.77 / $29.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.93 / $15.69 / $19.93
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.73 / $13.73 / $16.63
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.73 / $13.73 / $235.31
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.12 / $13.73 / $16.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.96 / $8.24 / $14.91