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Maine rates for HCPCS 11976

Removal, implantable contraceptive capsules

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.89 / $199.53 / $6,309.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $147.91 / $323.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $147.91 / $234.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $173.78 / $323.59
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $177.83 / $281.84
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.89 / $199.53 / $6,309.57
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $147.91 / $363.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $169.82 / $281.84