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Maine rates for HCPCS 01402

Anesth Open/Surg Arthrs Total Knee Arthroplasty

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
QK
Low / Median / High Price
$634.95 / $747.00 / $772.50
Aetna
Facility/Professional
Facility
Modifier
QX
Low / Median / High Price
$710.37 / $879.39 / $879.39
Martin's Point
Facility/Professional
Facility
Modifier
QK
Low / Median / High Price
$634.95 / $747.00 / $772.50
Martin's Point
Facility/Professional
Facility
Modifier
QX
Low / Median / High Price
$710.37 / $710.37 / $879.39