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Maine rates for HCPCS J1953

Levetiracetam Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.09 / $98.60 / $376.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.06
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.12 / $0.12 / $0.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.04
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.05
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.09 / $30.38 / $342.37
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.06 / $0.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.07