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Maine rates for HCPCS J9017

Injection, arsenic trioxide, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.98 / $18.62 / $117.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.08 / $12.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.24 / $9.12 / $22.91
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.41 / $7.41 / $7.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.61 / $7.41 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.41 / $7.41 / $9.33
Community Health Options
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.71 / $45.71 / $45.71
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.46 / $6.46 / $7.41
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.98 / $16.98 / $18.62
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.41 / $24.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.41 / $7.41 / $10.96