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Maine rates for HCPCS J3410

Injection Hydroxyzine Hcl Up To 25 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.91 / $38.25 / $572.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.91 / $20.49 / $20.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.31 / $47.31 / $47.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $15.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.30 / $15.30 / $15.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $15.30
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $18.53
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.50 / $38.25 / $168.53
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.91 / $20.49 / $38.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.30 / $15.30 / $22.95