go back

Maine rates for HCPCS Q4125

ArthroFlex, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.91 / $138.91 / $138.91
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.03 / $40.21 / $40.75
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.91 / $138.91 / $138.91