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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
$2,884.03 / $2,884.03 / $2,884.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $1,380.38 / $5,248.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $316.23 / $776.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $501.19 / $6,456.54
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $3,235.94 / $6,025.60
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $2,884.03 / $2,884.03
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $1,148.15 / $6,456.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $1,412.54 / $6,309.57