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Maine rates for HCPCS 14041

Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,076.94 / $11,076.94 / $11,076.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$612.01 / $822.45 / $1,508.06
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$829.26 / $995.73 / $1,503.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$719.57 / $1,238.15 / $1,838.07
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$950.53 / $1,166.68 / $1,941.76
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,076.94 / $11,076.94 / $11,076.94
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$612.01 / $868.09 / $1,747.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$756.70 / $1,300.20 / $1,870.62