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Maine rates for HCPCS 0055T

Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on CT/MRI images (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,456.54 / $6,456.54 / $6,456.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $208.93 / $407.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $186.21 / $234.42
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $229.09 / $446.68
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,456.54 / $6,456.54 / $6,456.54
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $218.78 / $398.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $234.42 / $446.68