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Maine rates for HCPCS 41115

Excision of lingual frenum (frenectomy)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$938.88 / $938.88 / $938.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.11 / $236.74 / $404.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.97 / $281.04 / $416.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$244.35 / $244.35 / $456.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.57 / $316.47 / $551.09
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$182.19 / $318.22 / $554.40
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.19 / $255.88 / $427.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$205.42 / $347.90 / $533.34