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Maine rates for HCPCS 50130

Pyelotomy With Removal Calculus

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,323.96 / $1,323.96 / $1,491.02
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
$1,244.51 / $1,374.07 / $2,106.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,231.86 / $1,541.64 / $2,208.67
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,145.71 / $1,475.58 / $2,263.62
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,323.96 / $1,323.96 / $1,491.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,088.94 / $1,464.69 / $2,041.12