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Maine rates for HCPCS 99478

Subsequent Intensive Care Infant < 1500 Grams

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.96 / $122.43 / $202.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.80 / $160.19 / $251.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$152.16 / $152.16 / $152.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.49 / $177.52 / $291.55
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.91 / $186.95 / $291.64
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.96 / $141.88 / $213.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.74 / $193.10 / $267.02