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Maine rates for HCPCS 42260

Repair Nasolabial Fistula

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$706.57 / $852.32 / $1,002.94
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$805.09 / $998.61 / $1,494.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$863.00 / $863.00 / $1,137.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$740.00 / $1,112.91 / $1,889.59
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$836.77 / $1,066.35 / $1,892.68
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$706.57 / $869.64 / $1,609.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$802.33 / $1,151.05 / $1,813.36