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Maine rates for HCPCS 96376

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.15 / $97.72 / $676.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $10.00 / $363.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.88 / $19.50 / $26.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.30 / $18.20 / $22.39
Community Health Options
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $316.23 / $316.23
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.30 / $14.45 / $16.22
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.15 / $117.49 / $676.08
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $10.23 / $17.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.88 / $19.50 / $21.88