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Maine rates for HCPCS L3390

Outflare Wedge (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.47 / $35.38 / $35.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.84 / $67.17 / $124.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.94 / $34.06 / $34.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.99 / $43.99 / $43.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.11 / $32.11 / $43.99
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.19 / $47.19 / $47.19
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.83 / $35.38 / $35.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.38 / $29.08 / $66.87