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Maine rates for HCPCS J3260

Injection Tobramycin Sulfate Up To 80 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.50 / $13.10 / $26.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.37 / $2.47 / $3.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.33 / $7.33 / $7.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.37 / $2.37 / $2.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.37 / $2.37 / $2.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.37 / $2.37 / $2.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.37 / $2.37 / $2.87
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.50 / $5.93 / $26.57
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.37 / $2.47 / $4.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.37 / $2.37 / $3.82