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Maine rates for HCPCS 78456

Acute Venous Thrombosis Imaging Peptide

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.55 / $356.04 / $356.04
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$740.76 / $1,023.21 / $1,679.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$313.80 / $369.18 / $550.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$365.02 / $511.63 / $680.92
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$347.48 / $350.95 / $754.31
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.55 / $356.04 / $464.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.36 / $441.57 / $591.46