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Maine rates for HCPCS J0257

Injection, alpha 1 proteinase inhibitor (human), (GLASSIA), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.08 / $13.08 / $14.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.86 / $6.91 / $6.91
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.46 / $6.85 / $17.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $5.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.64 / $5.64 / $5.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $5.64
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $5.64 / $6.83
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.08 / $13.08 / $14.10
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.86 / $6.91 / $14.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.65 / $5.64 / $8.18