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Maine rates for HCPCS J2792

Injection Rho D Immune Globulin Intravenous Human Solvent Detergent 100 Iu (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.07 / $59.07 / $63.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.46 / $26.48 / $37.22
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.64 / $30.93 / $80.68
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.46 / $25.46 / $25.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.46 / $25.46 / $25.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.46 / $25.46 / $25.46
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.46 / $25.46 / $30.83
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.07 / $59.07 / $63.65
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.46 / $37.22 / $63.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.46 / $25.46 / $38.19