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Maine rates for HCPCS J1000

Injection, depo-estradiol cypionate, up to 5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.33 / $114.33 / $123.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.25 / $54.74 / $56.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$152.37 / $152.37 / $152.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.28 / $49.28 / $49.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.28 / $49.28 / $49.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.28 / $49.28 / $49.28
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.28 / $49.28 / $59.68
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.33 / $114.33 / $123.20
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.25 / $56.76 / $123.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.89 / $49.28 / $71.45