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Maine rates for HCPCS Q4175

MiroDerm Bio Matrix Fenestrat EX SHEE 2X2CM

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.54 / $95.20 / $95.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.54 / $91.54 / $91.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.54 / $91.54 / $91.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.54 / $91.54 / $91.54
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.54 / $91.54 / $91.54
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.54 / $95.20 / $95.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.54 / $91.54 / $132.72