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Maine rates for HCPCS J1260

Injection, dolasetron mesylate, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.22 / $17.78 / $17.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.01 / $5.01 / $11.75
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $6.03 / $6.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.17 / $6.17 / $6.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.17 / $6.17 / $6.17
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.17 / $6.17 / $12.30
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.22 / $16.22 / $17.78
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.01 / $5.01 / $11.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.17 / $12.30 / $17.78