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Maine rates for HCPCS 42200

Palatop Cl Palate Soft&/Hard Palate Only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,076.49 / $4,076.49 / $4,076.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$783.04 / $1,108.77 / $1,486.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,008.40 / $1,256.20 / $1,914.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$982.00 / $982.00 / $1,043.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$818.37 / $1,212.71 / $2,006.85
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,038.32 / $1,337.27 / $2,092.60
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,076.49 / $4,076.49 / $4,076.49
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$900.50 / $1,139.76 / $1,728.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$866.29 / $1,218.07 / $2,000.73