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Maine rates for HCPCS 54690

Laparoscopy Surgical Orchiectomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,301.55 / $4,402.08 / $4,402.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$654.46 / $654.46 / $1,156.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$760.17 / $873.04 / $1,378.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$789.43 / $982.06 / $1,406.98
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$730.60 / $940.95 / $1,443.47
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,301.55 / $3,301.55 / $4,402.08
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$654.46 / $654.46 / $1,156.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$729.95 / $1,026.64 / $1,302.83