go back

Maine rates for HCPCS J0725

Injection Chorionic Gonadotropin Per 1 000 Usp Units (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.78 / $42.78 / $46.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.18 / $21.19 / $25.32
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.01 / $57.01 / $57.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.44 / $18.44 / $18.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.44 / $18.44 / $18.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.44 / $18.44 / $18.44
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.44 / $18.44 / $22.33
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.78 / $42.78 / $46.10
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.18 / $21.19 / $46.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.44 / $18.44 / $26.75