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Maine rates for HCPCS 80204

Drug Assay Methotrexate

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.57 / $38.57 / $172.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.24 / $31.24 / $38.57
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.32 / $56.70 / $267.17
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.43 / $15.43 / $32.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.40 / $41.40 / $42.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.07 / $40.60 / $55.24
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.57 / $38.57 / $46.71
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.57 / $38.57 / $172.41
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.24 / $31.24 / $38.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.14 / $23.14 / $55.93