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Maine rates for HCPCS 26489

Transfer or transplant of tendon, palmar; with free tendon graft (includes obtaining graft), each tendon

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
$870.96 / $1,096.48 / $2,511.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,412.54 / $2,089.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,479.11 / $1,479.11
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,380.38 / $2,630.27
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
$912.01 / $1,318.26 / $2,818.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,202.26 / $2,089.30