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Maine rates for HCPCS J9177

Injection, enfortumab vedotin-ejfv, 0.25 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $91.20 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $36.31 / $45.71
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.48 / $42.66 / $117.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $36.31 / $38.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.31 / $36.31 / $54.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $36.31 / $36.31
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $36.31 / $37.15
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $85.11 / $91.20
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $38.02 / $57.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $36.31 / $43.65