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Maine rates for HCPCS J1555

Injection, immune globulin (Cuvitru), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.07 / $39.07 / $42.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.52 / $21.28 / $21.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.30 / $20.46 / $53.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.84 / $16.84 / $16.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.84 / $16.84 / $16.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.84 / $16.84 / $16.84
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.84 / $16.84 / $20.39
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.07 / $39.07 / $42.10
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.52 / $21.28 / $42.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.03 / $16.84 / $25.26