go back

Maine rates for HCPCS J0400

Injection, aripiprazole, intramuscular, 0.25 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.75 / $0.75 / $0.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.75 / $0.75 / $0.75
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.92
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.15
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $2.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.86 / $0.86 / $1.29