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Maine rates for HCPCS 0485T

Optical coherence tomography (OCT) of middle ear, with interpretation and report; unilateral

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.03 / $40.99 / $46.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.07 / $186.58 / $233.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.09 / $45.09 / $48.90
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.78 / $21.02 / $45.63
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.79 / $40.99 / $44.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.60 / $52.20 / $90.44