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Maine rates for HCPCS 64755

Transection or avulsion of; vagus nerves limited to proximal stomach (selective proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, supra- or highly selective vagotomy)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,047.13 / $2,454.71
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22,908.68 / $24,547.09 / $33,113.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,412.54 / $1,995.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,230.27 / $1,995.26
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,288.25 / $2,454.71
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,230.27 / $2,884.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,202.26 / $1,905.46