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Maine rates for HCPCS J2840

Injection Sebelipase Alfa 1 Mg (Reinstated 01/01/2017). Savacort-50 Up To 50 Mg (Del 03/31/2003)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,421.23 / $1,421.23 / $1,531.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$520.71 / $520.71 / $520.71
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$522.47 / $655.83 / $1,710.97
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$520.71 / $520.71 / $520.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$520.71 / $520.71 / $520.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$520.71 / $520.71 / $520.71
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$520.71 / $520.71 / $630.58
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,421.23 / $1,421.23 / $1,531.50
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$520.71 / $520.71 / $1,531.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$510.50 / $510.50 / $740.23