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Massachusetts rates for HCPCS 15572

Formation of direct or tubed pedicle, with or without transfer; scalp, arms, or legs

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$673.43 / $2,663.12 / $4,410.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.23 / $783.29 / $1,458.33
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,653.36 / $5,066.04 / $9,401.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$672.28 / $1,351.57 / $5,330.80
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$873.75 / $1,135.88 / $2,004.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$824.48 / $1,310.07 / $2,785.65
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$736.87 / $1,593.20 / $6,679.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$979.58 / $1,230.90 / $1,699.12
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$915.05 / $1,876.77 / $2,723.79
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.00 / $5,066.04 / $26,542.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$882.72 / $1,675.43 / $6,371.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.00 / $4,983.00 / $8,810.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$737.83 / $1,292.34 / $2,859.24