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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
$85.24 / $16,773.91 / $16,773.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.74 / $38.21 / $44.36
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.68 / $40.84 / $116.43
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.74 / $36.74 / $38.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.64 / $36.74 / $36.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.74 / $36.74 / $36.74
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.74 / $36.74 / $36.74
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.24 / $85.24 / $16,773.91
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.74 / $38.21 / $61.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.74 / $36.74 / $53.27