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Maine rates for HCPCS J1573

Injection Hepatitis B Immune Globulin (Hepagam B) Intravenous 0.5ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.61 / $154.61 / $166.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.31 / $86.71 / $86.71
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.48 / $80.95 / $211.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.64 / $66.64 / $66.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.64 / $66.64 / $66.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.64 / $66.64 / $66.64
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.64 / $66.64 / $80.70
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.61 / $154.61 / $166.60
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.31 / $86.71 / $166.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.64 / $66.64 / $111.87