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Maine rates for HCPCS 28490

Cltx Fx Grt Toe Phlx/Phlg W/O Manj

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.84 / $140.85 / $245.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.25 / $168.56 / $246.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.97 / $202.16 / $294.44
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.99 / $194.08 / $326.30
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.62 / $157.90 / $280.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.03 / $188.66 / $297.55