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Maine rates for HCPCS A4802

Protamine sulfate, for hemodialysis, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.10 / $13.58 / $15.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.20 / $13.58 / $13.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.58 / $13.58 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.58 / $13.58 / $13.58
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.10 / $13.58 / $15.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.45 / $2.17 / $4.42