go back

Maine rates for HCPCS 21395

Optx Orb Floor Blwt Fx Pri/Bital Appr W/Bone Grf

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$841.39 / $1,058.43 / $1,284.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,055.76 / $1,366.28 / $1,922.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,021.18 / $1,534.23 / $2,177.79
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,253.50 / $1,450.30 / $2,224.84
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$841.39 / $1,145.54 / $1,284.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$965.99 / $1,378.54 / $1,999.95