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Maine rates for HCPCS 65781

Ocular Surface Reconstruction Limbal Allograft

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,043.70 / $2,043.70 / $2,127.06
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,322.77 / $1,698.69 / $2,513.02
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.59 / $1,876.18 / $2,878.16
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,043.70 / $2,043.70 / $2,043.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,284.10 / $1,858.39 / $2,419.48