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Maine rates for HCPCS L6642

Upper Extremity Addition Excursion Amplifier Lever Type

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.47 / $214.99 / $214.99
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$283.91 / $367.83 / $681.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.44 / $166.55 / $239.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.78 / $225.10 / $234.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.32 / $164.32 / $225.10
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$258.45 / $258.45 / $258.45
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.74 / $214.99 / $214.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$172.06 / $172.06 / $172.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.17 / $159.25 / $366.23