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Maine rates for HCPCS 53454

Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.91 / $30.90 / $190.55
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $42.66 / $102.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $67.61 / $309.03
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $69.18 / $107.15
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.91 / $28.18 / $54.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $44.67 / $107.15