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Maine rates for HCPCS 21242

Arthroplasty Temporomandibular Jt W/Allograft

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$841.86 / $1,078.99 / $1,298.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,052.24 / $1,361.72 / $1,925.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,025.69 / $1,557.75 / $2,203.76
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,257.21 / $1,454.59 / $2,231.42
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$841.86 / $1,186.42 / $1,298.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$986.58 / $1,352.40 / $2,030.43