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Maine rates for HCPCS J1097

Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml

Facilitymedian $355 · 10th–90th $135–$1,9050%20%40%10th90th$355Professionalmedian $120 · 10th–90th $112–$1200%50%10th$120$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $354.81 / $1,905.46
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $117.49 / $120.23
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $112.20 / $309.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $120.23 / $120.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $346.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $144.54
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $117.49 / $120.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $120.23 / $169.82