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Maine rates for HCPCS 21210

Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,659.59 / $3,981.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,122.02 / $1,819.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,995.26 / $3,715.35
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $2,238.72 / $3,548.13
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $2,041.74 / $4,466.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,698.24 / $3,548.13