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Maine rates for HCPCS 96375

Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.00 / $23.48 / $25.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.57 / $19.51 / $34.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.30 / $29.54 / $35.03
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.14 / $20.99 / $32.20
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.00 / $19.52 / $28.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.01 / $30.31 / $33.44