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Maine rates for HCPCS 0055T

Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on CT/MRI images (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,442.14 / $6,442.14 / $6,442.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.23 / $202.50 / $405.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$182.87 / $186.81 / $189.12
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.39 / $304.75 / $467.51
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,442.14 / $6,442.14 / $6,442.14
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.23 / $376.40 / $432.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.88 / $236.18 / $428.60