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Maine rates for HCPCS C1789

Prothesis, breast (implantable)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,815.85 / $9,848.64 / $22,646.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$402.32 / $402.32 / $402.32
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.01 / $20.01 / $20.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,054.93 / $1,054.93 / $1,054.93
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,917.13 / $8,444.50 / $19,130.74
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$402.32 / $402.32 / $867.84