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Maine rates for HCPCS 15576

Formation of direct or tubed pedicle, with or without transfer; eyelids, nose, ears, lips, or intraoral

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$529.07 / $692.41 / $1,272.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$712.55 / $852.31 / $1,269.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.35 / $1,075.14 / $1,583.39
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$809.15 / $993.15 / $1,641.26
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$529.07 / $718.48 / $1,272.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$767.25 / $1,113.27 / $1,578.84