go back

Maine rates for HCPCS J0121

Injection Omadacycline 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.33 / $9.33 / $10.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.18 / $4.84 / $5.52
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.89 / $4.88 / $12.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.01 / $4.01 / $4.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.09 / $4.09 / $4.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.09 / $4.09 / $4.09
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.01 / $4.01 / $4.87
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.33 / $9.33 / $10.05
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.18 / $4.84 / $10.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.01 / $4.01 / $5.83