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Maine rates for HCPCS 31623

Brnchsc Brushing/Protected Brushings

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.80 / $2,005.27 / $3,254.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.78 / $249.76 / $385.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.94 / $246.07 / $415.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.78 / $343.45 / $619.79
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.93 / $302.91 / $524.65
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.40 / $438.81 / $3,254.79
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.88 / $240.51 / $432.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$336.01 / $458.10 / $589.75