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Maine rates for HCPCS J2425

Injection Palifermin 50 Micrograms

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.48 / $82.48 / $88.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.97 / $43.45 / $43.45
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.40 / $43.18 / $112.66
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.54 / $35.54 / $35.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.99 / $35.54 / $35.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.54 / $35.54 / $35.54
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.54 / $35.54 / $43.05
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.48 / $82.48 / $88.88
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.97 / $43.45 / $88.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.54 / $35.54 / $51.55