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Maine rates for HCPCS J9203

Injection, gemtuzumab ozogamicin, 0.1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$548.96 / $548.96 / $591.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $246.08 / $286.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$210.45 / $263.05 / $749.85
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $245.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$233.12 / $236.62 / $236.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $236.62
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $236.62
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$548.96 / $548.96 / $591.54
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $248.45 / $397.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $343.10