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Maine rates for HCPCS 22515

Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; each additional thoracic or lumbar vertebral body (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,882.30 / $2,882.30 / $2,882.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.34 / $407.75 / $5,084.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$249.27 / $293.26 / $410.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$271.97 / $469.91 / $6,917.97
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.11 / $812.82 / $5,434.92
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,882.30 / $2,882.30 / $2,882.30
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$212.75 / $392.65 / $5,221.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.09 / $5,557.62 / $7,264.43