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Maine rates for HCPCS 21087

Impression & Preparation Nasal Prosthesis

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,312.90 / $1,746.86 / $2,118.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,460.72 / $1,684.02 / $2,428.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,609.27 / $2,362.62 / $3,415.15
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,607.58 / $1,981.86 / $3,517.60
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,312.90 / $1,746.86 / $2,118.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,607.58 / $2,439.86 / $3,398.64