go back

Maine rates for HCPCS 0100T

Placement of a subconjunctival retinal prosthesis receiver and pulse generator, and implantation of intra-ocular retinal electrode array, with vitrectomy

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $1,778.28 / $2,344.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,548.82 / $1,819.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $707.95 / $707.95
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,454.71 / $3,630.78
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,778.28 / $2,290.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $2,511.89 / $3,630.78