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Maine rates for HCPCS 67500

Retrobulbar Injection Medication Spx

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.83 / $111.97 / $123.30
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.53 / $78.12 / $104.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$712.05 / $712.05 / $712.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $123.20 / $161.88
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.55 / $95.31 / $147.52
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.09 / $93.83 / $111.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.01 / $110.01 / $142.71