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Maine rates for HCPCS 01472

Anes Rpr Ruptured Achilles Tendon W/Wo Graft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
AA
Low / Median / High Price
$1,222.20 / $1,222.20 / $1,222.20
Aetna
Facility/Professional
Facility
Modifier
QX
Low / Median / High Price
$569.99 / $569.99 / $569.99
Martin's Point
Facility/Professional
Facility
Modifier
AA
Low / Median / High Price
$1,222.20 / $1,222.20 / $1,222.20
Martin's Point
Facility/Professional
Facility
Modifier
QX
Low / Median / High Price
$569.99 / $569.99 / $569.99