go back

Maine rates for HCPCS J1566

Injection Immune Globulin Intravenous Lyophilized (E.G. Powder) 500 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$182.82 / $182.82 / $197.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.95 / $87.53 / $108.21
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.25 / $95.72 / $249.72
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.80 / $78.80 / $78.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.79 / $78.79 / $78.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.79 / $78.79 / $78.79
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.80 / $78.80 / $95.43
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$182.82 / $182.82 / $197.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.95 / $98.86 / $197.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.80 / $78.80 / $118.20