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Maine rates for HCPCS J9205

Injection Irinotecan Liposome 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.12 / $153.12 / $165.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.00 / $68.64 / $78.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.70 / $73.37 / $209.15
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.00 / $66.00 / $68.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.22 / $66.00 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.00 / $66.00 / $66.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.00 / $66.00 / $66.00
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.12 / $153.12 / $165.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.00 / $68.66 / $90.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.00 / $66.00 / $95.70