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Maine rates for HCPCS J1554

Injection, immune globulin (Asceniv), 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,152.44 / $1,152.44 / $1,241.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$516.61 / $600.78 / $600.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$480.70 / $603.39 / $1,574.17
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.74 / $496.74 / $496.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$496.74 / $496.74 / $496.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.74 / $496.74 / $496.74
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.74 / $496.74 / $601.54
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,152.44 / $1,152.44 / $1,241.84
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$516.61 / $600.78 / $1,241.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.74 / $496.74 / $720.27