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Maine rates for HCPCS 21268

Orbital Repositioning W/Bone Grafts Icra & Xtrc

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,667.22 / $2,123.94 / $2,583.58
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,491.08 / $26,019.37 / $30,263.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,106.23 / $2,725.73 / $3,824.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,042.78 / $2,970.31 / $4,354.71
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,496.28 / $2,888.20 / $4,430.64
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,667.22 / $2,133.67 / $2,583.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,756.83 / $2,454.71 / $3,989.97