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Maine rates for HCPCS 25690

Closed Tx Lunate Dislocation W/Manipulation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$411.80 / $527.57 / $614.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$520.29 / $673.33 / $968.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$522.09 / $754.82 / $1,076.68
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$632.30 / $731.58 / $1,122.29
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$411.80 / $543.30 / $614.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$453.06 / $639.37 / $1,015.11