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Maine rates for HCPCS L8658

Interphalangeal Joint Spacer Silicone Or Equal Each. (Rvsd 1/1/04)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.41 / $328.96 / $328.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.02 / $233.77 / $366.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$228.90 / $228.90 / $358.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.57 / $194.57 / $228.90
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$395.46 / $395.46 / $395.46
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.02 / $328.96 / $328.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.44 / $243.67 / $676.31