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Maine rates for HCPCS 50120

Pyelotomy W/Exploration

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,216.79 / $1,216.79 / $1,363.16
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
$1,145.70 / $1,263.21 / $1,939.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,131.03 / $1,418.09 / $2,031.66
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,054.60 / $1,358.26 / $2,083.64
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,216.79 / $1,216.79 / $1,363.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.53 / $1,346.37 / $1,879.33