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Maryland rates for HCPCS 15574

Frmj Dir/Tube Pedcl W/Wotr Fh/Ch/Ch/M/N/Ax/G/H/F

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,275.10 / $6,275.10 / $8,681.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$732.99 / $820.19 / $901.43
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$836.97 / $836.97 / $997.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$686.75 / $901.75 / $1,537.98
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$892.06 / $1,131.38 / $2,001.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$450.00 / $450.00 / $450.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.64 / $982.88 / $1,812.81
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$726.79 / $795.30 / $1,031.40