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Maine rates for HCPCS 0651T

Magnetically controlled capsule endoscopy, esophagus through stomach, including intraprocedural positioning of capsule, with interpretation and report

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.85 / $249.22 / $262.39
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$803.81 / $915.66 / $1,147.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$287.45 / $287.45 / $699.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.06 / $1,202.06 / $1,202.06
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$285.50 / $367.71 / $575.39
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.85 / $249.22 / $262.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.95 / $354.10 / $521.12