go back

Maine rates for HCPCS 43763

Perq Replacement Gtube Req Revj Gstrst Trc

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.57 / $333.28 / $411.05
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.28 / $217.74 / $509.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$148.19 / $148.19 / $699.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.54 / $237.49 / $645.19
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.41 / $339.86 / $691.27
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.89 / $205.80 / $411.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.69 / $449.70 / $679.54