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Maine rates for HCPCS G0103

Prostate cancer screening; prostate specific antigen test (PSA)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.30 / $122.84 / $234.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.64 / $21.48 / $28.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.69 / $25.78 / $185.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.72 / $7.72 / $21.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.19 / $25.19 / $42.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.16 / $22.13 / $27.66
Community Health Options
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.80 / $30.80 / $135.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.30 / $22.34 / $34.27
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.30 / $87.73 / $470.75
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.64 / $21.48 / $31.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.59 / $15.04 / $36.34