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Massachusetts rates for HCPCS 21084

Impression and custom preparation; speech aid prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,346.52 / $1,346.52 / $1,714.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,203.08 / $1,667.63 / $2,728.71
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,281.01 / $4,751.20 / $7,942.01
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,281.01 / $2,676.44 / $11,568.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,397.54 / $1,795.84 / $3,205.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,550.10 / $2,475.48 / $4,399.55
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$300.00 / $1,909.00 / $8,090.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,816.81 / $2,200.76 / $3,008.42
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,526.54 / $3,237.72 / $4,480.41
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $5,063.00 / $12,850.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,850.64 / $3,418.66 / $11,568.56
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,324.00 / $5,097.00 / $10,764.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,770.47 / $2,598.40 / $4,725.74