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Maine rates for HCPCS J2504

Injection, pegademase bovine, 25 IU

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$966.42 / $966.42 / $1,041.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.08 / $354.08 / $354.08
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$327.26 / $443.47 / $1,166.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.96 / $367.96 / $367.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$367.96 / $367.96 / $367.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.96 / $367.96 / $367.96
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$966.42 / $966.42 / $1,041.40
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.08 / $354.08 / $1,041.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$357.54 / $357.54 / $518.42