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Maine rates for HCPCS 15200

Fth/Gft Free W/Direct Closure Trunk 20 Sq Cm/<

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,024.44 / $3,024.44 / $3,024.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$536.16 / $668.72 / $1,083.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$718.87 / $885.76 / $1,313.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$656.54 / $1,107.77 / $1,659.10
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$840.06 / $1,054.54 / $1,757.85
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,024.44 / $3,024.44 / $3,024.44
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$536.16 / $683.98 / $1,083.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$802.32 / $1,141.58 / $1,692.69