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Maine rates for HCPCS 64804

Sympathectomy Cervicothoracic

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$804.11 / $1,078.83 / $1,348.09
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,186.79 / $1,535.57 / $2,404.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,266.40 / $1,743.22 / $2,511.71
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,512.36 / $1,749.80 / $2,684.29
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$804.11 / $1,183.51 / $1,348.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$987.82 / $1,379.69 / $2,335.33