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Maine rates for HCPCS J2357

Injection Omalizumab 5 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$103.47 / $111.50 / $5,364.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.60 / $46.38 / $61.24
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.16 / $54.18 / $141.34
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.60 / $44.60 / $44.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.60 / $44.60 / $44.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.60 / $44.60 / $44.60
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.60 / $44.60 / $54.01
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$103.47 / $103.47 / $3,917.89
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.60 / $46.38 / $65.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.60 / $44.60 / $64.67