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Maine rates for HCPCS J9021

Injection Asparaginase Recombinant (Rylaze) 0.1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.69 / $128.69 / $138.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $57.69 / $66.91
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.34 / $61.67 / $175.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $55.47 / $57.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.14 / $55.47 / $55.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $55.47 / $55.47
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $55.47 / $55.47
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.69 / $128.69 / $138.68
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $58.25 / $92.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.47 / $55.47 / $80.43