go back

Maine rates for HCPCS 99480

Subsequent Intensive Care Infant 2501-5000 Grams

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.54 / $104.58 / $177.09
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.95 / $152.32 / $219.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$132.90 / $132.90 / $132.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.72 / $154.41 / $255.88
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.05 / $163.58 / $255.19
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.54 / $114.99 / $213.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.45 / $168.68 / $251.11