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Maine rates for HCPCS J7643

Glycopyrrolate Comp Unit

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.06 / $2.06 / $2.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.04 / $1.04 / $1.26
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.06 / $2.06 / $2.23
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $2.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.89 / $1.34