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Maine rates for HCPCS 40701

Plstc Rpr Cl Lip/Nsl Dfrm Prim Bi 1 Stg Px

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,188.03 / $1,443.79 / $1,885.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,241.44 / $1,606.57 / $2,459.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,019.72 / $1,656.44 / $2,560.85
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,485.16 / $1,779.37 / $2,636.01
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,188.03 / $1,443.79 / $1,885.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,165.61 / $1,485.16 / $2,362.89