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Maine rates for HCPCS 76145

Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,981.07 / $4,073.80 / $4,265.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $891.25 / $1,174.90
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $4,677.35 / $4,677.35
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,288.25 / $1,621.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,380.38 / $2,238.72
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,513.56 / $2,951.21
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,981.07 / $4,073.80 / $4,265.80
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,023.29 / $2,884.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,288.25 / $2,290.87