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Massachusetts rates for HCPCS 21087

Impression & Preparation Nasal Prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,443.64 / $1,443.64 / $1,759.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,290.88 / $1,759.05 / $2,795.48
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,369.61 / $4,751.20 / $10,667.33
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,369.61 / $2,836.62 / $11,734.30
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,493.88 / $1,919.64 / $3,426.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,616.59 / $2,625.76 / $4,551.13
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$300.00 / $2,026.59 / $8,090.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,829.44 / $2,216.05 / $3,015.81
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,637.38 / $3,393.12 / $4,588.60
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
$1,977.62 / $3,444.11 / $11,734.30
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
$1,895.07 / $2,818.14 / $4,690.16