go back

Maine rates for HCPCS 11976

Removal Implantable Contraceptive Capsules

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$124.46 / $198.58 / $6,353.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.17 / $115.73 / $230.62
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.87 / $152.77 / $219.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.71 / $172.72 / $287.13
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.77 / $178.48 / $300.49
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$124.46 / $198.58 / $6,353.76
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.17 / $121.28 / $230.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.47 / $197.11 / $291.62