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Maine rates for HCPCS J9395

Injection, fulvestrant, 25 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.61 / $1,751.60 / $4,364.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.73 / $7.00 / $8.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.99 / $7.48 / $21.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.73 / $6.73 / $6.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.66 / $6.73 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.73 / $6.73 / $6.73
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.73 / $6.73 / $6.73
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.61 / $15.61 / $1,751.60
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.73 / $7.00 / $9.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.73 / $6.73 / $10.10