go back

Massachusetts rates for HCPCS 15769

Grafting Of Autologous Soft Tiss By Direct Exc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$693.92 / $2,704.85 / $5,048.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$384.82 / $521.38 / $1,414.70
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$818.35 / $4,402.00 / $11,102.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$415.72 / $727.55 / $1,646.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$523.65 / $718.66 / $1,230.97
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$480.59 / $1,038.52 / $6,679.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$531.04 / $662.06 / $913.90
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$597.61 / $1,132.47 / $1,695.88
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$869.94 / $869.94 / $1,626.89
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,383.14 / $1,383.14 / $1,452.29
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $5,268.00 / $11,102.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$507.57 / $728.42 / $3,475.60
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
$504.44 / $726.96 / $1,558.60