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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
$61.66 / $66.07 / $66.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $21.88 / $25.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.39 / $26.92 / $74.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $22.39 / $24.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.39 / $22.39 / $42.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.39 / $22.39 / $22.39
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.44 / $23.44 / $23.44
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $61.66 / $66.07
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $21.88 / $28.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $22.91 / $26.30