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Maine rates for HCPCS 0258U

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,675.00 / $3,675.00 / $7,809.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,675.00 / $3,675.00 / $3,675.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,365.38 / $23,510.45 / $27,403.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,470.00 / $1,470.00 / $3,123.75
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,675.00 / $3,675.00 / $3,711.75
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,675.00 / $3,675.00 / $5,953.50
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,675.00 / $3,675.00 / $3,675.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,874.25 / $2,205.00 / $6,431.25