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Maine rates for HCPCS J0741

Injection Cabotegravir And Rilpivirine 2mg/3mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.87 / $54.87 / $59.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.59 / $26.27 / $32.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.89 / $28.73 / $74.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.65 / $23.65 / $23.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.65 / $23.65 / $23.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.65 / $23.65 / $23.65
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.65 / $23.65 / $28.64
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.87 / $54.87 / $59.13
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.89 / $26.27 / $47.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.65 / $23.65 / $35.47