go back

Maine rates for HCPCS 52001

Cysto W/Irrig & Evac Multple Obstructing Clots

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$366.69 / $366.69 / $531.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.29 / $423.64 / $564.75
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$345.50 / $473.40 / $659.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$359.06 / $540.66 / $805.47
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$350.78 / $518.96 / $807.50
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$366.69 / $449.33 / $564.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$410.56 / $547.51 / $883.05