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Maryland rates for HCPCS 21175

Rcnstj Bifrontal Superior-Lat Orb Rims & Lwr Fhd

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,001.22 / $2,207.96 / $5,788.87
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,586.60 / $2,617.98 / $3,010.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$507.00 / $507.00 / $641.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,942.84 / $2,996.39 / $4,968.46
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,289.53 / $2,966.10 / $3,856.05
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$774.00 / $1,560.00 / $11,831.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,735.61 / $2,299.26 / $4,263.09
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,958.93 / $2,644.20 / $3,255.42