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Maine rates for HCPCS J7169

Injection, coagulation Factor Xa (recombinant), inactivated-zhzo (Andexxa), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$346.74 / $371.54 / $371.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $123.03 / $125.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.89 / $151.36 / $416.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $128.82 / $128.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.82 / $128.82 / $147.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $128.82 / $128.82
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $128.82 / $154.88
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$346.74 / $346.74 / $371.54
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $125.89 / $151.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $128.82 / $218.78