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Maine rates for HCPCS 21390

Open treatment of orbital floor blowout fracture; periorbital approach, with alloplastic or other implant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,126.96 / $4,126.96 / $4,126.96
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,126.96 / $4,126.96 / $4,126.96