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Maine rates for HCPCS 50075

Nephrolithotomy Rmvl Large Staghorn Calculus

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,867.70 / $1,867.70 / $2,103.30
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,783.47 / $23,063.27 / $26,006.75
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,751.56 / $1,938.06 / $2,962.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,751.72 / $2,171.13 / $3,110.52
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,610.81 / $2,074.58 / $3,182.52
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,867.70 / $1,867.70 / $2,103.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,572.49 / $2,283.15 / $3,722.23