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Maine rates for HCPCS J1742

Injection, ibutilide fumarate, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$847.77 / $847.77 / $913.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$310.61 / $310.61 / $310.61
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$182.38 / $247.14 / $649.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$310.60 / $310.60 / $310.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$310.61 / $310.61 / $310.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$310.61 / $310.61 / $310.61
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$205.06 / $205.06 / $248.33
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$847.77 / $847.77 / $913.55
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$310.61 / $310.61 / $913.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$205.06 / $298.30 / $472.19