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Massachusetts rates for HCPCS 21155

Rcnstj Midface Lefort Iii W/Lefort I

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,924.00 / $2,747.00 / $5,039.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,948.01 / $2,224.39 / $3,433.02
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,591.00 / $5,349.73 / $13,773.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,244.77 / $3,938.51 / $22,628.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,306.19 / $3,829.80 / $6,189.58
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$300.00 / $3,196.43 / $8,090.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,441.19 / $2,957.10 / $4,011.76
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,650.93 / $5,015.82 / $6,602.41
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $5,063.00 / $15,883.52
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,425.85 / $4,089.03 / $22,628.38
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
$2,422.98 / $3,445.81 / $6,728.06