go back

Maine rates for HCPCS 70487

Ct Maxillofacial W/Contrast Material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$61.23 / $64.59 / $73.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.57 / $287.22 / $345.99
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$56.06 / $62.26 / $82.56
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$116.69 / $193.59 / $271.94
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.78 / $211.95 / $319.98
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$55.45 / $72.00 / $109.88
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$108.14 / $139.94 / $210.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.64 / $300.77 / $488.89
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$59.28 / $86.99 / $119.36
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$131.56 / $198.67 / $350.48
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.85 / $229.65 / $414.30
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$65.54 / $78.87 / $142.27
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$125.31 / $150.79 / $272.02
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$61.23 / $64.59 / $73.59
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$183.04 / $257.74 / $353.25
Martin's Point
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$56.89 / $64.59 / $117.60
Martin's Point
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$119.13 / $168.81 / $271.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.14 / $238.61 / $421.16
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$55.77 / $80.68 / $142.27
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$111.88 / $149.03 / $278.83