go back

Maine rates for HCPCS 43204

Esophagoscopy Flex Transoral Injection Varices

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.02 / $163.82 / $285.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.97 / $194.00 / $274.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.61 / $151.61 / $456.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.21 / $233.12 / $368.74
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.86 / $191.71 / $300.01
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.76 / $163.82 / $318.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.31 / $202.32 / $305.05