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Maine rates for HCPCS G0068

Professional Services For The Administration Of Anti-Infective Pain Management Chelation Pulmonary Hypertension Inotropic Or Other Intravenous Infusion Drug Or Biological (Excludingchemotherapy Or Other Highly Complex Drug Or Biological) For Each Infusion Drug Administration Calendar Day In The Individuals Home Each 15 Minutes (Desc Rvsd 1/1/21)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.56 / $128.56 / $128.56
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.44 / $70.00 / $70.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.60 / $141.60 / $141.60
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.47 / $252.77 / $387.76
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.56 / $128.56 / $128.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.56 / $201.19 / $260.16