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Maine rates for HCPCS 38200

Injection Procedure Splenoportograpy

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.86 / $139.05 / $156.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.19 / $194.83 / $274.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.10 / $201.39 / $285.95
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.28 / $190.48 / $343.59
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.86 / $139.05 / $157.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.94 / $168.55 / $293.30