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Maine rates for HCPCS 33612

Repair of double outlet right ventricle with intraventricular tunnel repair; with repair of right ventricular outflow tract obstruction

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,175.58 / $2,988.70 / $2,988.70
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,071.30 / $2,550.64 / $3,780.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,460.02 / $2,988.70 / $4,186.24
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.36 / $2,434.87 / $3,788.66
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,175.58 / $2,988.70 / $2,988.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,118.96 / $2,988.56 / $3,413.90