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Maine rates for HCPCS 64415

Injection Aa&/Strd Brachial Plexus W/Img Gdn

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.06 / $661.83 / $738.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.64 / $109.00 / $176.81
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.38 / $83.98 / $136.31
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$107.08 / $125.97 / $204.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.20 / $137.65 / $252.73
Community Health Options
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,936.50 / $1,936.50 / $1,936.50
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.74 / $164.47 / $264.04
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.06 / $157.22 / $935.79
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.44 / $112.94 / $179.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.74 / $153.36 / $255.92