go back

Maine rates for HCPCS Q4187

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$483.52 / $483.52 / $483.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.30 / $255.11 / $272.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.30 / $245.30 / $245.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.30 / $245.30 / $245.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.30 / $245.30 / $245.30
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.30 / $245.30 / $245.30
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$483.52 / $483.52 / $483.52
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.30 / $255.11 / $497.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$221.06 / $245.30 / $355.69