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Maryland rates for HCPCS J2515

Injection Pentobarbital Sodium Per 50 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.87 / $53.87 / $7,163.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.87 / $53.87 / $68.95
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.60 / $22.60 / $22.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.87 / $53.87 / $53.87
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.32 / $10.55 / $57.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.82 / $52.82 / $55.99
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.13 / $24.13 / $24.13