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Maine rates for HCPCS 49507

Rpr 1st Ingun Hrna Age 5 Yrs/> Incarcerated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,893.77 / $5,348.46 / $17,410.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$670.45 / $670.45 / $1,835.00
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$66.25 / $66.25 / $66.25
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$802.02 / $13,019.54 / $62,717.76