go back

Maine rates for HCPCS L0859

Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$637.07 / $885.02 / $885.02
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,296.78 / $1,680.10 / $3,114.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$816.05 / $875.81 / $875.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$969.19 / $969.19 / $969.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.51 / $707.51 / $969.19
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,180.52 / $1,180.52 / $1,180.52
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$820.98 / $885.02 / $885.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$484.94 / $727.41 / $1,672.82