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Maine rates for HCPCS 15572

Formation of direct or tubed pedicle, with or without transfer; scalp, arms, or legs

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$590.63 / $705.76 / $1,458.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$793.95 / $953.69 / $1,435.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$684.47 / $1,223.06 / $1,750.99
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$920.85 / $1,130.25 / $1,852.92
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$590.63 / $778.37 / $1,458.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$884.52 / $1,220.73 / $1,774.41