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Maine rates for HCPCS A4257

Replacement lens shield cartridge for use with laser skin piercing device, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $10.96 / $15.85
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.46 / $6.46 / $7.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.24 / $7.24
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $15.49 / $15.85
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $12.02 / $35.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.89 / $8.91 / $15.49