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Maine rates for HCPCS 21725

Division Sternocleidomastoid Open W/Cast

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$453.27 / $572.57 / $682.66
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$570.05 / $737.73 / $1,053.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$563.99 / $819.19 / $1,175.02
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$687.96 / $795.97 / $1,221.06
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$453.27 / $618.86 / $682.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$455.74 / $711.17 / $1,094.77