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Maine rates for RC 0259

Pharmacy - Other Pharmacy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,614.00 / $1,614.00 / $1,922.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.17 / $76.95 / $161.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,860.00 / $2,146.00 / $3,929.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.40 / $38.79 / $45.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00