go back

Maine rates for HCPCS A4617

Mouth Piece (Special Coverage Instructions Apply. See Cim: 60-4 And Mcm: 3312)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.27 / $1.79 / $2.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.12 / $2.13 / $2.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.76 / $6.76 / $6.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.77 / $1.77 / $3.06
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.53 / $3.53 / $3.53
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.27 / $1.89 / $2.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.44 / $2.16 / $4.80