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Maine rates for HCPCS J1570

Ganciclovir Sodium Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.73 / $91.73 / $98.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.12 / $47.94 / $47.94
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.25 / $122.25 / $122.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.54 / $39.54 / $39.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.54 / $39.54 / $39.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.54 / $39.54 / $39.54
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.54 / $39.54 / $47.88
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.73 / $91.73 / $98.85
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.12 / $47.94 / $98.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.54 / $39.54 / $69.20