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Maine rates for HCPCS J9325

Injection Talimogene Laherparepvec Per 1 Millionplaque Forming Units

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$171.54 / $171.54 / $184.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.94 / $76.89 / $89.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.75 / $82.19 / $234.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.94 / $73.94 / $76.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.37 / $73.94 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.94 / $73.94 / $73.94
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.94 / $73.94 / $73.94
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$171.54 / $171.54 / $184.85
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.94 / $77.63 / $123.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.94 / $73.94 / $107.21