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Maine rates for HCPCS A6504

Compression Burn Garment Glove To Wrist Custom Fabricated

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.00 / $90.00 / $90.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.00 / $150.00 / $150.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.80 / $90.80 / $90.80
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.00 / $90.00 / $90.00