go back

Maine rates for HCPCS J1245

Injection, dipyridamole, per 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.51 / $19.51 / $21.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.67 / $8.41 / $9.33
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.00 / $26.00 / $26.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.41 / $8.41 / $8.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.41 / $8.41 / $8.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.41 / $8.41 / $8.41
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.41 / $8.41 / $10.18
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.51 / $19.51 / $21.03
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.67 / $8.41 / $21.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.19 / $8.41 / $12.19