go back

Maine rates for HCPCS J3355

Injection, urofollitropin, 75 IU

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$348.42 / $348.42 / $375.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.65 / $127.65 / $127.65
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.43 / $63.43 / $63.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.43 / $63.43 / $63.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.43 / $63.43 / $63.43
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$348.42 / $348.42 / $375.45
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.65 / $127.65 / $375.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.43 / $125.15 / $181.47