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Maine rates for HCPCS 41250

Repair of laceration 2.5 cm or less; floor of mouth and/or anterior two-thirds of tongue

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,650.78 / $1,650.78 / $1,650.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$259.45 / $259.45 / $611.00
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,650.78 / $1,650.78 / $1,650.78