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Massachusetts rates for HCPCS 21088

Impression & Preparation Facial Prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,103.45 / $1,103.45 / $1,103.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$961.45 / $1,122.20 / $3,615.87
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$818.35 / $5,047.31 / $14,212.24
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,924.20 / $5,082.25 / $36,897.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,955.36 / $6,331.89 / $9,490.32
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $3,504.00 / $9,239.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,216.52 / $6,216.52 / $7,313.55
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,303.09 / $9,943.29 / $12,743.33
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $5,063.00 / $14,212.24
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,874.43 / $4,829.80 / $36,897.44
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
$1,874.43 / $4,432.88 / $13,075.23