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Maine rates for HCPCS L3255

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.57 / $19.57 / $23.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.00 / $189.00 / $189.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.72 / $23.72 / $23.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.32 / $17.32 / $23.72
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
$19.57 / $19.57 / $24.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.90 / $50.90 / $52.94