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Maine rates for HCPCS 21215

Graft Bone Mandible

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$780.12 / $1,276.54 / $5,284.97
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$896.15 / $1,054.29 / $1,520.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,034.06 / $3,204.16 / $8,278.17
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$992.99 / $3,021.67 / $7,927.05
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$762.19 / $1,276.54 / $5,284.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,518.98 / $5,612.20 / $8,315.24