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Maine rates for HCPCS L3254

Non-Standard Size Or Width (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.38 / $14.38 / $15.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.38 / $65.38 / $65.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.75 / $10.75 / $10.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $9.57 / $10.75
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.94 / $52.94 / $52.94
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.38 / $14.38 / $28.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.90 / $52.94 / $52.94