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Maine rates for HCPCS 58752

Tubouterine Implantation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$919.29 / $919.29 / $938.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,268.63 / $22,395.57 / $25,253.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,002.45 / $1,203.95 / $1,739.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,089.36 / $1,297.02 / $1,968.28
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,010.55 / $1,301.50 / $1,996.57
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$919.29 / $919.29 / $938.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,005.71 / $1,338.15 / $1,802.73