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Maine rates for HCPCS J0120

Injection, tetracycline, up to 250 mg

Facilitymedian $42 · 10th–90th $39–$420%50%10th$42Professionalmedian $13 · 10th–90th $1–$400%20%40%10th90th$13$1.0$2.0$5.0$10.0$20.0$50.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $41.69 / $41.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $14.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $1.00 / $1.15
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $48.98
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $14.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.24 / $39.81 / $39.81