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Maine rates for HCPCS J3030

Injection Sumatriptan Succinate 6 Mg (Code May Be Used For Medicare When Drug Administered Under The Direct Supervision Of A Physician Not For Use When Drug Is Self Administered) (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.74 / $103.01 / $111.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.85 / $37.74 / $38.33
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.40 / $114.40 / $114.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.74 / $37.74 / $37.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.74 / $37.74 / $37.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.74 / $37.74 / $37.74
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.74 / $37.74 / $45.70
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.74 / $103.01 / $111.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.85 / $37.74 / $111.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.00 / $37.00 / $76.40