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Illinois rates for HCPCS 00104

Anesthesia Electroconvulsive Therapy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
QX
Low / Median / High Price
$61.64 / $61.64 / $97.00
Aetna
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$358.29 / $390.28 / $524.60
Ambetter
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$127.84 / $127.84 / $149.15