go back

Maine rates for HCPCS J7321

Hyaluronan or derivative, Hyalgan, Supartz or Visco-3, for intra-articular injection, per dose

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.93 / $165.93 / $178.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.23 / $74.40 / $98.21
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$221.13 / $221.13 / $221.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.52 / $71.52 / $71.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.52 / $71.52 / $71.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.52 / $71.52 / $71.52
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.52 / $71.52 / $86.61
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.93 / $165.93 / $178.80
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.23 / $79.45 / $154.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.52 / $71.52 / $117.94