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Maine rates for HCPCS 90586

Bacillus Calmette-Guerin Vaccine Intravesical

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.97 / $188.95 / $196.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$503.92 / $503.92 / $503.92
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.28 / $173.28 / $173.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.27 / $203.81 / $203.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.81 / $203.81 / $203.81
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.97 / $188.57 / $289.27
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.97 / $188.95 / $196.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.97 / $164.26 / $285.22