go back

Maine rates for HCPCS J0122

Inj., eravacycline, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.02 / $3.02 / $3.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.35 / $1.56 / $1.56
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.26 / $1.58 / $4.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.30 / $1.30 / $1.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.33 / $1.33 / $1.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.33 / $1.33 / $1.33
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.30 / $1.30 / $1.57
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.02 / $3.02 / $3.25
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.35 / $1.56 / $3.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.30 / $1.30 / $1.95