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Maine rates for HCPCS 57155

Insertion Uterine Tandem&/Vaginal Ovoids

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,206.66 / $3,206.66 / $3,206.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.22 / $348.38 / $449.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.91 / $421.01 / $636.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$362.07 / $547.08 / $862.17
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.55 / $500.82 / $822.38
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,206.66 / $3,206.66 / $3,206.66
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.22 / $364.16 / $673.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$427.69 / $599.94 / $836.14