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Massachusetts rates for HCPCS 21142

Rcnstj Midface Lefort I 2 Pieces W/O Bone Graft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,342.59 / $2,747.00 / $5,048.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,198.75 / $1,350.29 / $2,190.23
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,499.57 / $4,751.20 / $12,850.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,307.98 / $2,385.71 / $13,111.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,379.96 / $2,193.87 / $3,963.92
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,364.27 / $2,204.64 / $6,679.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,565.50 / $1,896.34 / $2,586.78
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,683.87 / $3,297.02 / $4,292.18
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
$1,435.08 / $2,506.46 / $13,111.43
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
$1,426.62 / $2,159.38 / $4,476.43