go back

Maine rates for HCPCS J1990

Injection, chlordiazepoxide HCl, up to 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $66.07 / $66.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $21.88 / $56.23
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
$17.78 / $20.89 / $23.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.89 / $20.89 / $20.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $20.89 / $20.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $20.89 / $25.70
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $61.66 / $66.07
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $21.88 / $56.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $20.89 / $30.20