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Maine rates for HCPCS 50520

Closure Nephrocutaneous/Pyelocutaneous Fistula

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,465.04 / $1,465.04 / $1,486.04
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
$1,405.15 / $1,545.66 / $2,388.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,243.86 / $1,731.83 / $2,481.15
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,299.01 / $1,673.02 / $2,566.51
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,465.04 / $1,465.04 / $1,486.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,128.57 / $1,578.04 / $2,263.69