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Maine rates for HCPCS 55874

Transperineal Plmt Biodegradable Matrl 1/Mlt Njx

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,201.28 / $2,201.28 / $5,196.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.33 / $357.20 / $4,452.72
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.14 / $342.95 / $4,624.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.13 / $352.58 / $5,348.15
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.39 / $466.81 / $5,245.87
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,201.28 / $3,361.97 / $5,196.31
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.56 / $357.20 / $4,047.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,797.22 / $5,245.87 / $6,161.19