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Maine rates for HCPCS J1885

Injection Ketorolac Tromethamine Per 15 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.58 / $8.00 / $40.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.32 / $0.43
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.36 / $0.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.30 / $0.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.30 / $0.30 / $0.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.30 / $0.30
Community Health Options
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.30 / $0.36
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.75 / $7.70 / $63.02
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.32 / $0.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.30 / $0.53