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Maryland rates for HCPCS 76513

Dx Ophthalmic Us Ant Segment Immersion Uni/Bi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$27.37 / $27.37 / $27.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.92 / $79.73 / $254.51
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$27.21 / $31.00 / $90.34
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$203.05 / $359.52 / $973.29
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$38.54 / $49.35 / $119.79
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.96 / $99.95 / $145.63
CareFirst
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$34.40 / $38.22 / $43.25
CareFirst
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$55.56 / $61.73 / $107.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.80 / $100.93 / $183.46
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$24.76 / $39.18 / $74.30
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$35.04 / $61.28 / $119.52
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.78 / $97.51 / $174.29
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$32.42 / $39.54 / $58.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$44.36 / $57.22 / $111.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.98 / $96.54 / $185.49
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$26.20 / $36.81 / $68.94
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$43.35 / $63.12 / $112.33
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.48 / $88.30 / $109.77
Wellpoint
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$31.87 / $37.28 / $47.19
Wellpoint
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$43.62 / $51.01 / $63.65