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Maryland rates for HCPCS 40700

Plstc Rpr Cl Lip/Nsl Dfrm Prim Prtl/Compl Uni

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,693.12 / $6,693.12 / $6,693.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$863.37 / $1,143.30 / $1,188.83
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,048.04 / $1,094.59 / $1,260.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$873.45 / $1,112.59 / $1,820.94
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,059.50 / $1,227.11 / $2,231.12
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,236.00 / $1,236.00 / $1,236.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$755.71 / $1,013.36 / $2,032.65
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$814.20 / $1,115.56 / $1,218.43