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Maine rates for HCPCS 54111

Exc Penile Plaque Graft &/5 Cm Length

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$798.07 / $798.07 / $1,388.56
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$925.09 / $1,062.74 / $1,677.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$958.76 / $1,194.93 / $1,711.95
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$889.09 / $1,145.07 / $1,756.60
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$798.07 / $798.07 / $1,388.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$885.62 / $1,173.75 / $1,752.13