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Maine rates for HCPCS J9120

Injection, dactinomycin, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$761.75 / $761.75 / $820.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.34 / $341.47 / $366.53
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$292.02 / $365.02 / $1,040.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.34 / $328.34 / $340.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$324.80 / $328.34 / $752.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.34 / $328.34 / $328.34
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.34 / $328.34 / $328.34
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$761.75 / $761.75 / $820.85
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.34 / $344.75 / $508.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.34 / $328.34 / $476.09