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Maine rates for HCPCS V2523

Contact Lens Hydrophilic Extended Wear Per Lens (Special Coverage Instructions Apply. See Cim: 45-7 65-1)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.48 / $133.97 / $148.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.26 / $549.26 / $549.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$235.34 / $240.98 / $240.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.76 / $86.76 / $86.76
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.45 / $190.45 / $190.45
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.48 / $133.97 / $148.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.17 / $116.51 / $267.93