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Maine rates for HCPCS J0401

Injection, aripiprazole (Abilify Maintena), 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.98 / $18.20 / $18.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.08 / $2,290.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.08 / $8.51 / $22.91
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.24 / $7.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.24 / $7.24 / $7.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.24 / $7.24
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.24 / $8.71
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.98 / $16.98 / $18.20
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.76 / $18.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.75 / $7.24 / $10.47