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Maine rates for HCPCS 54130

Amputation Penis Radw/Bi Inguinofemoral Lmphade

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,189.52 / $1,189.52 / $2,067.21
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,065.14 / $15,647.20 / $17,644.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,382.64 / $1,584.68 / $2,496.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,423.57 / $1,781.74 / $2,552.65
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,323.45 / $1,704.49 / $2,614.78
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,189.52 / $1,189.52 / $2,067.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,323.45 / $1,888.30 / $2,358.65