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Maine rates for HCPCS J7177

Injection, human fibrinogen concentrate (Fibryga), 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.85 / $2.85 / $3.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.27 / $1.46 / $1.46
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.19 / $1.49 / $3.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.23 / $1.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.23 / $1.23 / $1.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.23 / $1.23
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.23 / $1.49
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.85 / $2.85 / $3.08
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.27 / $1.46 / $3.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.23 / $1.78