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Maine rates for HCPCS J2406

Injection, oritavancin (Kimyrsa), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$98.55 / $98.55 / $106.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.18 / $50.09 / $50.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.11 / $51.60 / $134.62
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.48 / $42.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.48 / $42.48 / $42.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.48 / $42.48
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.48 / $51.44
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$98.55 / $98.55 / $106.20
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.18 / $50.09 / $106.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.48 / $63.72