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Maine rates for HCPCS 0486T

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.84 / $81.61 / $93.55
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.78 / $373.17 / $467.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.59 / $128.59 / $139.50
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.78 / $65.81 / $123.48
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.84 / $78.55 / $93.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.62 / $103.92 / $178.65