go back

Maine rates for HCPCS 12054

Repair Intermediate F/E/E/N/L&/Muc 7.6-12.5 Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$175.96 / $793.87 / $793.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.96 / $300.80 / $365.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.77 / $384.58 / $579.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$282.94 / $467.23 / $746.28
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$273.29 / $469.91 / $791.14
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$612.14 / $706.86 / $793.87
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.96 / $300.80 / $440.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$358.58 / $493.90 / $843.76