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Maine rates for HCPCS 96522

Refill&Maintenance Pump Drug Dlvr Systemic

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.04 / $144.35 / $154.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.32 / $180.56 / $340.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.59 / $160.59 / $273.58
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.05 / $162.01 / $299.77
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.04 / $144.35 / $154.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.83 / $151.79 / $240.72