go back

Maine rates for HCPCS Q4218

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.00 / $127.50 / $127.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.50 / $127.50 / $127.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$127.50 / $127.50 / $127.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.50 / $127.50 / $127.50
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.50 / $127.50 / $127.50
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.50 / $127.50 / $127.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.00 / $150.00 / $217.50