go back

Maine rates for HCPCS 15738

Muscle, myocutaneous, or fasciocutaneous flap; lower extremity

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,100.64 / $1,100.64 / $1,100.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,033.99 / $1,211.20 / $1,978.71
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,233.05 / $1,646.02 / $2,415.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$984.75 / $1,821.90 / $2,738.66
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,571.31 / $1,882.59 / $2,788.92
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,100.64 / $1,100.64 / $1,100.64
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,033.99 / $1,303.58 / $2,336.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,394.57 / $1,913.82 / $2,506.23