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Maine rates for HCPCS 64495

Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 3+ Level

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.76 / $1,301.82 / $1,301.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.57 / $79.45 / $104.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.64 / $67.81 / $100.27
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$86.46 / $101.72 / $150.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.45 / $111.68 / $186.44
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.07 / $110.88 / $178.01
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$786.71 / $786.71 / $1,301.82
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.64 / $80.40 / $151.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.56 / $116.98 / $156.68