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Maine rates for HCPCS J1726

Injection, hydroxyprogesterone caproate, (Makena), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $60.26 / $60.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $19.95 / $19.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.60 / $19.95 / $22.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.49 / $15.49 / $15.49
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $19.95 / $24.55
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $56.23 / $60.26
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $19.95 / $23.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $19.95 / $28.18