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Maine rates for HCPCS 58301

Removal of intrauterine device (IUD)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68.09 / $891.41 / $3,713.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.53 / $89.18 / $146.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.29 / $114.89 / $166.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.06 / $137.46 / $244.21
Community Health Options
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.19 / $177.19 / $185.68
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.62 / $134.88 / $210.37
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.91 / $1,551.71 / $6,653.72
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.09 / $102.79 / $146.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.11 / $130.97 / $221.18