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Maine rates for HCPCS L4000

Replace Girdle For Spinal Orthotic (Cervic-Thoracic-Lumbar-Sacor

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$752.31 / $1,045.11 / $1,045.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,531.40 / $1,984.06 / $3,677.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$874.87 / $916.66 / $916.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$897.58 / $897.58 / $1,265.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$655.23 / $655.23 / $897.58
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,394.09 / $1,394.09 / $1,394.09
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$969.51 / $1,045.11 / $1,045.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$957.27 / $957.27 / $957.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$572.66 / $883.45 / $1,975.44