go back

Maine rates for HCPCS J1364

Injection, erythromycin lactobionate, per 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.77 / $50.12 / $50.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $19.95 / $24.55
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $61.66 / $61.66
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $19.95 / $19.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.95 / $19.95 / $19.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $19.95 / $19.95
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $91.20 / $109.65
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.77 / $46.77 / $50.12
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $19.95 / $60.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $19.95 / $66.07