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Maine rates for HCPCS J1096

Dexamethasone Lacrimal Ophthalmic Insert 0.1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$238.82 / $238.82 / $257.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.05 / $122.80 / $122.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.61 / $125.03 / $326.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.94 / $102.94 / $102.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.94 / $102.94 / $102.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.94 / $102.94 / $102.94
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.94 / $102.94 / $124.66
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$238.82 / $238.82 / $257.35
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.05 / $122.80 / $257.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.94 / $102.94 / $180.15