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Maine rates for HCPCS J2670

Injection Tolazoline Hcl Up To 25 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.58 / $9.58 / $10.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.51 / $3.51 / $3.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.77 / $3.44 / $3.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.44 / $3.44 / $3.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.44 / $3.44 / $3.44
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.44 / $3.44 / $4.17
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.58 / $9.58 / $10.33
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.51 / $3.51 / $10.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.13 / $4.13 / $6.20