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Maine rates for HCPCS L8041

Midfacial prosthesis, provided by a nonphysician

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $1,862.09 / $5,888.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $4,466.84 / $5,128.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $1,949.84 / $2,570.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $2,884.03 / $2,884.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,454.71 / $2,454.71 / $2,884.03
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,311.31 / $3,311.31 / $3,981.07
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $2,511.89 / $5,888.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $1,023.29 / $2,137.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $2,398.83 / $3,388.44