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Maryland rates for HCPCS 40801

Drg Absc Cst Hmtma Vestibule Mouth Comp

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,277.95 / $8,277.95 / $8,277.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.02 / $293.77 / $1,110.19
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$193.31 / $213.98 / $244.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$287.92 / $287.92 / $287.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.35 / $341.33 / $647.16
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$294.32 / $395.77 / $682.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.01 / $350.09 / $605.28
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$256.85 / $352.82 / $436.65