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Maine rates for HCPCS 15574

Formation of direct or tubed pedicle, with or without transfer; forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands or feet

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$601.57 / $719.55 / $739.39
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$809.93 / $960.84 / $1,441.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$689.85 / $1,236.46 / $1,785.22
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$901.48 / $1,106.48 / $1,801.57
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$601.57 / $754.58 / $982.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$866.14 / $1,260.36 / $1,783.71