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Maine rates for HCPCS J0791

Injection Crizanlizumab-Tmca 5 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$300.39 / $300.39 / $323.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.66 / $156.79 / $177.81
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.30 / $157.28 / $410.32
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.47 / $129.47 / $129.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$129.47 / $129.47 / $129.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.47 / $129.47 / $129.47
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.47 / $129.47 / $156.80
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$300.39 / $300.39 / $323.70
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.66 / $148.90 / $323.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.47 / $129.47 / $187.75