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Maine rates for HCPCS J1212

Injection, DMSO, dimethyl sulfoxide, 50%, 50 ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.33 / $1,737.33 / $1,872.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$778.80 / $898.91 / $1,028.39
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.66 / $909.63 / $2,373.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$748.85 / $748.85 / $748.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$748.84 / $748.84 / $748.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$748.84 / $748.84 / $748.84
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$748.85 / $748.85 / $906.86
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.33 / $1,737.33 / $1,872.13
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$778.80 / $861.17 / $1,872.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$636.52 / $748.85 / $1,123.28