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Maine rates for HCPCS J2779

Injection Ranibizumab Via Intravitreal Implant (Susvimo) 0.1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$183.12 / $183.12 / $197.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.09 / $87.69 / $94.90
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.38 / $95.88 / $250.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.93 / $78.93 / $78.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.93 / $78.93 / $78.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.93 / $78.93 / $78.93
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.93 / $78.93 / $95.58
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$183.12 / $183.12 / $197.33
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.09 / $94.90 / $197.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.93 / $78.93 / $114.45