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Maine rates for HCPCS 15738

Muscle, myocutaneous, or fasciocutaneous flap; lower extremity

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,096.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,348.96 / $3,715.35
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.15 / $1,698.24 / $3,162.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,819.70 / $2,884.03
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,698.24 / $2,511.89
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,096.48
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,737.80 / $3,890.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,778.28 / $2,511.89