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Maine rates for HCPCS 12017

Simple Repair F/E/E/N/L/M 20.1cm-30.0 Cm

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.68 / $121.68 / $121.68
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.79 / $188.69 / $292.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.61 / $231.03 / $321.99
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.61 / $227.17 / $336.54
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.68 / $121.68 / $204.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.80 / $216.41 / $336.54