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Maine rates for HCPCS J9313

Injection Moxetumomab Pasudotox-Tdfk 0.01 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.43 / $61.43 / $66.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.71 / $22.51 / $26.48
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.80 / $26.00 / $74.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.07 / $22.50 / $24.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.51 / $22.51 / $23.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.51 / $22.51 / $22.51
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.39 / $23.39 / $23.39
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.43 / $61.43 / $66.20
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.71 / $22.51 / $26.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.07 / $22.07 / $32.00