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Maine rates for HCPCS 54115

Removal Foreign Body Deep Penile Tissue

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$423.75 / $453.52 / $787.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$491.57 / $576.38 / $817.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$529.66 / $689.79 / $988.24
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$514.35 / $617.13 / $946.71
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$423.75 / $453.52 / $787.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$454.85 / $701.18 / $922.83