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Maine rates for HCPCS 40720

Plstc Rpr Cl Lip/Nsl Dfrm Sec Recrtj Dfct & Recl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,891.10 / $3,891.10 / $3,891.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$866.94 / $1,244.47 / $1,630.94
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,069.88 / $1,384.55 / $2,122.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$879.15 / $1,429.05 / $2,207.81
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,281.94 / $1,535.89 / $2,275.32
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,891.10 / $3,891.10 / $3,891.10
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$996.98 / $1,152.14 / $1,630.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,029.16 / $1,435.36 / $2,039.10