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Maine rates for HCPCS 19371

Peri-implant capsulectomy, breast, complete, including removal of all intracapsular contents

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$631.22 / $2,201.28 / $2,201.28
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$7,703.63 / $7,703.63 / $17,880.22
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,201.28 / $2,201.28 / $2,201.28
Martin's Point
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$7,703.63 / $7,703.63 / $17,880.22