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Maine rates for HCPCS J9050

Carmustine 100 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$553.23 / $553.23 / $596.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$210.10 / $247.99 / $250.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$212.09 / $265.10 / $755.68
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.46 / $238.46 / $247.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$238.46 / $238.46 / $765.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.46 / $238.46 / $238.46
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.46 / $238.46 / $238.46
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$553.23 / $553.23 / $596.15
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$210.10 / $247.99 / $291.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.46 / $238.46 / $417.31