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Maryland rates for HCPCS L8604

Injectable Bulking Agent Dextranomer/Hyaluronic Acid Copolymer Implant

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,374.87 / $2,374.87 / $2,374.87
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.53 / $109.53 / $109.53