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Maine rates for HCPCS 84081

Phosphatidylglycerol

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.52 / $16.52 / $41.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.38 / $13.38 / $16.52
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.99 / $22.05 / $172.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.61 / $6.61 / $19.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.66 / $23.13 / $35.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.69 / $22.48 / $23.77
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.52 / $16.52 / $20.01
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.52 / $16.52 / $41.30
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.38 / $13.38 / $16.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.91 / $13.50 / $33.75