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Maine rates for HCPCS J9155

Degarelix Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.32 / $4,924.64 / $4,924.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $4.63 / $5.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.96 / $4.95 / $14.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $4.45 / $4.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.28 / $4.45 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $4.45 / $4.45
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $4.45 / $4.45
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.32 / $10.32 / $4,924.64
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $4.86 / $6.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $4.45 / $6.68