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Maine rates for HCPCS J7202

Injection, Factor IX, albumin fusion protein, (recombinant), Idelvion, 1 IU

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.34 / $12.34 / $13.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.53 / $6.46 / $6.46
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.15 / $6.46 / $16.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.32 / $5.32 / $5.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.32 / $5.32 / $5.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.32 / $5.32 / $5.32
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.32 / $5.32 / $6.44
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.34 / $12.34 / $13.30
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.53 / $6.46 / $13.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.51 / $5.32 / $7.98